Walking Economy after an Arm-ergometry versus a Treadmill Supervised Exercise program in patients with Peripheral...

Peripheral artery disease (PAD) significantly affects patient prognosis, leading to a rapid decline in physical function and health-related quality of life. PAD impacts walking economy, causing higher oxygen uptake during submaximal walking, which is crucial for evaluating walking performance and aerobic endurance.

How do arm-ergometry supervised exercise training (AEx) and treadmill exercise training (TEx) compare in their effects on walking economy, and what clinical characteristics and outcomes influence the degree of this improvement?

This study is an ancillary investigation of the ARMEX trial, a single-center, single-blinded, parallel groups, noninferiority randomized clinical trial. Patients with symptomatic PAD were randomized (1:1 ratio) either to a 12-week AEx or TEx. Walking economy was measured by oxygen uptake (V̇O₂) during submaximal effort during the treadmill cardiopulmonary exercise test (CPET).

Fifty-six patients (66 ± 8.4 years; 87.5 % male) were enrolled and randomized: AEx (n = 28) and TEx (n = 28). At 12-weeks, V̇O₂ at 60 until 240 s decreased only in TEx. Between-group differences were found at 60 until 240 s favoring TEx. Exercising in the TEx group and lower baseline body mass index (BMI) were independently associated with a greater improvement in walking economy. Changes in walking economy were inversely correlated with changes in V̇O₂ peak and positively correlated with CPET maximum walking distance and self-reported walking distance.

Treadmill exercise improved walking economy more than arm-ergometry in patients with PAD. Individuals with a higher BMI experience less improvement in walking economy with exercise training and might require specialized interventions.