Upper versus lower limb exercise training in patients with intermittent claudication: a systematic review

Area of Science:

• Rehabilitation Medicine
• Exercise Physiology
• Clinical Trials

Background:

• Lower extremity (LE) exercise training is established for improving outcomes in intermittent claudication (IC).
• The comparative efficacy of upper extremity (UE) exercise training for IC remains less understood.
• The International Classification of Functioning (ICF) provides a framework for evaluating exercise interventions.

Purpose of the Study:

• To systematically review and synthesize evidence comparing UE versus LE exercise training in patients with IC.
• To evaluate the impact of UE and LE exercises on functional capacity and quality of life.

Main Methods:

• Systematic literature review of randomized controlled trials (RCTs).
• Included studies compared UE exercise training directly against LE exercise training.
• Study quality was assessed using the PEDro scale.

Main Results:

• Six RCTs were included, with two deemed high quality.
• Both UE and LE exercise groups showed significant improvements in Maximum Walking Distance (MWD), Claudication Distance (CD), peak oxygen uptake (VO2peak), and Quality of Life (QoL) compared to controls.
• No significant difference was found in the effectiveness between UE and LE training.

Conclusions:

• Upper extremity (UE) exercise training is a viable and effective alternative to lower extremity (LE) training for managing intermittent claudication (IC).
• UE training can provide symptomatic relief and functional improvements without the discomfort associated with LE exercises.
• Further research may explore optimal UE training protocols for IC patients.