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Training guided by pain threshold speed. Effects of a home-based program on claudication.
F Manfredini1, F Conconi, A M Malagoni
1Vascular Diseases Center, University of Ferrara, Ferrara, Italy.
Summary
A home-based exercise program guided by pain threshold speed (PTS) significantly improved walking ability and functional parameters in patients with claudication. This low-cost intervention led to dramatic improvements, enhancing quality of life.
Area of Science:
- Vascular Medicine
- Exercise Physiology
- Rehabilitation Science
Background:
- Intermittent claudication is a common condition characterized by leg pain during exercise due to peripheral artery disease.
- Current management often involves supervised exercise programs, which can be costly and inaccessible.
- Home-based exercise offers a potentially more accessible and affordable alternative for managing claudication.
Purpose of the Study:
- To evaluate the effectiveness of a 120-day home-based exercise program for patients with stable claudication.
- To utilize pain threshold speed (PTS) as a personalized guide for exercise intensity.
- To assess improvements in functional parameters and symptom severity.
Main Methods:
- Twenty-nine patients with stable claudication participated in the study.
- A 120-day home-based walking program was prescribed, with intensity set at 20-30% below individual PTS.
- Measurements included ankle pressure (AP), ankle-brachial index (ABI), PTS, and maximal treadmill walking speed (Smax).
- Patients recorded daily exercise data, and PTS was reassessed to adjust training speed.
- Compliance was assessed, dividing patients into trained, free-walker, and untrained groups.
Main Results:
- The overall group showed a significant increase in ABI (0.65 to 0.71, p=0.01) and improvements in PTS (3.2 to 4.2 km/h, p=0.0001) and Smax (3.9 to 4.6 km/h, p=0.0001).
- The trained group (n=14) demonstrated significant improvements in ABI, PTS, and Smax, with symptom reduction up to complete pain disappearance.
- Improvements in the trained group included a significant increase in ABI (0.72 to 0.82, p<0.02) and PTS (3.6 to 5.4 km/h, p<0.02).
Conclusions:
- A home-based exercise program guided by PTS is a low-cost and effective intervention for patients with claudication.
- This approach leads to significant improvements in functional parameters, including walking distance and speed.
- Personalized exercise prescription based on PTS can enhance patient outcomes and potentially reduce healthcare costs.