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Intensity-dependent effects of exercise therapy on walking performance and aerobic fitness in symptomatic patients with lower-extremity peripheral artery disease: A systematic review and meta-analysis
- Source :
- Vascular medicine, vol. 27, no. 2, pp. 158-170
- Publication Year :
- 2022
-
Abstract
- We investigated how nonpain-based exercise therapy intensity (light-to-moderate or vigorous) affects improvements in walking performance and cardiorespiratory fitness of patients with symptomatic lower-extremity peripheral artery disease (PAD). We searched the Embase, MEDLINE, Cochrane, Web of Science, and Google Scholar databases up to April 2021 and included randomized controlled trials reporting training therapies targeting exercise intensity (heart rate, oxygen consumption, or perceived exertion). The main outcomes were walking performance (pain-free [PFWD] and maximal [MWD] walking distance) and cardiorespiratory fitness (V̇O 2peak ). Secondary subanalyses examined the training modality (walking or other modalities) and the approach (high-intensity interval or moderate-intensity training). A total of 1132 patients were included. Light-to-moderate was superior to vigorous exercise intensity in improving MWD (223 m [95% CI 174 to 271], p < 0.00001; 153 m [95% CI 113 to 193], p < 0.00001; respectively) and PFWD (130 m [95% CI 87 to 173], p < 0.00001; 83 m [95% CI 61 to 104], p < 0.00001; respectively). When training modalities were considered, walking at a vigorous intensity (272 m [95% CI 207 to 337], p < 0.00001) showed the largest improvement in MWD compared to other exercise modalities. A larger increase in V̇O 2peak was observed following vigorous (3.0 mL O 2 ·kg -1 ·min -1 [95% CI 2.4 to 3.6], p < 0.00001) compared to light-to-moderate (1.1 mL O 2 ·kg -1 ·min -1 [95% CI 0.4 to 1.7], p = 0.001) exercise intensity. These results indicate that vigorous was less effective than light-to-moderate intensity in improving walking performance, whereas it was more effective in improving V̇O 2peak . When the training modalities were considered, walking at a vigorous intensity showed the greatest improvement in MWD. (PROSPERO Registration No.: CRD42020199469).
- Subjects :
- medicine.medical_specialty
business.industry
Cardiorespiratory fitness
Walking
Intermittent Claudication
medicine.disease
Intermittent claudication
Exercise Therapy
law.invention
Peripheral Arterial Disease
Lower Extremity
Randomized controlled trial
Exercise Therapy/adverse effects
Exercise Therapy/methods
Humans
Intermittent Claudication/diagnosis
Intermittent Claudication/therapy
Peripheral Arterial Disease/diagnosis
Peripheral Arterial Disease/therapy
exercise therapy
high-intensity interval training
intermittent claudication
peripheral artery disease (PAD)
vascular rehabilitation
law
Heart rate
medicine
Exercise intensity
Physical therapy
Aerobic exercise
Peripheral artery disease (PAD)
medicine.symptom
Cardiology and Cardiovascular Medicine
business
High-intensity interval training
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Vascular medicine, vol. 27, no. 2, pp. 158-170
- Accession number :
- edsair.doi.dedup.....3c34df193c147b31842f1b6af1c18543