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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Walking Training Improves Systemic and Local Pathophysiological Processes in Intermittent Claudication.

Aluisio Andrade-Lima1, Natan Silva Junior1, Marcel Chehuen1

  • 1School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
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PubMed
Summary

Submaximal walking training improved nitric oxide (NO) bioavailability and reduced oxidative stress and inflammation in patients with intermittent claudication (IC). This exercise protocol enhances physiological adaptations beneficial for cardiovascular health.

Keywords:
AtherosclerosisCardiovascular riskIntermittent claudicationPhysical exercise

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Area of Science:

  • Exercise Physiology
  • Cardiovascular Health
  • Biochemistry

Background:

  • Intermittent claudication (IC) is associated with impaired nitric oxide (NO) bioavailability, increased inflammation, and oxidative stress.
  • Submaximal walking training (WT) is a potential intervention to mitigate these detrimental effects.

Purpose of the Study:

  • To investigate the impact of a 12-week submaximal WT program on NO bioavailability, inflammation, and oxidative stress markers in patients with IC.
  • To compare these effects against a control group undergoing stretching exercises.

Main Methods:

  • Randomized controlled trial with 32 male patients with IC allocated to WT or control (stretching) groups.
  • WT involved walking at pain threshold intensity; measurements included blood and muscle NO, eNOS, CAT, SOD, LPO, IL-6, CRP, TNF-α, ICAM, and VCAM at baseline and 12 weeks.

Main Results:

  • WT significantly increased blood NO, muscle eNOS, and antioxidant enzymes (SOD, CAT).
  • WT abolished the increase in lipid peroxidation (LPO) and reduced inflammatory markers (CRP, ICAM, VCAM, IL-6, TNF-α) in blood and muscle compared to the control group.

Conclusions:

  • Submaximal walking training at the pain threshold intensity improves NO bioavailability.
  • WT effectively decreases systemic and local oxidative stress and inflammation in patients with IC, contributing to cardiovascular health.