The effect of supervised exercise therapy for intermittent claudication on lower limb lean mass

Area of Science:

• Exercise Physiology
• Vascular Medicine
• Musculoskeletal Health

Background:

• Supervised exercise is a first-line treatment for intermittent claudication, improving walking capacity.
• Concerns exist regarding skeletal muscle atrophy from repetitive ischemia-reperfusion in treadmill-based programs.
• Preservation of skeletal muscle mass (SMM) and lean mass (LM) is vital for functional capacity and longevity.

Purpose of the Study:

• To assess the impact of a 12-week supervised treadmill exercise program on SMM and regional lower limb LM in patients with intermittent claudication.
• To evaluate changes in thigh and calf LM, considering the side of symptoms.

Main Methods:

• 36 patients with infrainguinal peripheral artery disease and calf claudication participated.
• Whole-body dual-energy X-ray absorptiometry (DXA) was used for SMM and LM measurements before and after the 12-week program.
• Walking performance was assessed via pain-free and 6-minute walking distance tests.

Main Results:

• No significant changes in total body SMM or calf LM were observed.
• A significant decrease in LM was detected in both symptomatic and asymptomatic thighs.
• Walking performance, including pain-free and 6-minute walking distance, improved significantly but was not correlated with LM changes.

Conclusions:

• Standard 12-week treadmill training for intermittent claudication did not cause calf LM loss but led to a significant bilateral thigh LM decrease.
• Further research is needed to understand the pathophysiology and functional/survival implications of these observed LM changes.
• Optimizing exercise modalities and outcome measures is crucial for managing intermittent claudication effectively.