Comparison of two treadmill training programs on walking ability and endothelial function in intermittent...

Area of Science:

• Cardiovascular Medicine
• Exercise Physiology
• Rehabilitation Science

Background:

• Intermittent claudication is a common condition affecting walking ability.
• Current exercise protocols vary, with some recommending training to the point of moderate pain and others advocating for pain-free exercise.
• The comparative effects of these approaches on functional capacity and vascular health remain an area of investigation.

Purpose of the Study:

• To compare the efficacy of moderate versus pain-free treadmill training on walking performance and endothelial function in patients with stable intermittent claudication.
• To assess the impact of these training regimens on inflammatory markers.

Main Methods:

• A randomized trial involving sixty patients with stable intermittent claudication.
• Participants were assigned to either pain-free treadmill training or moderate treadmill training, exercising 3 times weekly for 3 months.
• Outcomes measured included flow-mediated dilation (FMD), treadmill walking performance, high-sensitivity C-reactive protein (hs-CRP), and fibrinogen levels.

Main Results:

• Both training groups showed significant improvements in maximal walking time (approx. 100%) and pain-free walking time (approx. 90-120%).
• Flow-mediated dilation (FMD) increased significantly in both groups (56% in moderate, 36% in pain-free), indicating improved endothelial function.
• No significant changes in hs-CRP or fibrinogen levels were observed, suggesting no increase in inflammation.

Conclusions:

• Both moderate and pain-free treadmill training are equally effective in improving walking ability for patients with claudication.
• The observed improvements in FMD suggest a systemic benefit on endothelial function from both exercise protocols.
• These treadmill programs are safe and do not exacerbate inflammation, with pain-free training being a viable therapeutic option.