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Experimental Protocol of a Three-minute, All-out Arm Crank Exercise Test in Spinal-cord Injured and Able-bodied Individuals
Published on: June 8, 2017
Acute Responses to Arm-Crank Exercise on the Cardiovascular Function of Patients With Peripheral Artery Disease: A
Gustavo O Silva1, Paolo M Cunha, Max D Oliveira
1Author Affiliations: Post-graduate Programa in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil (Dr G.O. Silva, Mr Oliveira, Ms J.K.T.N.F. Silva, Dr Kanegusuku, Ms Correia, and Dr Ritti-Dias); Physical Education, Faculdade Pernambucana de Saude, Recife, Brazil (Dr G.O. Silva); Instituto Israelita de Ensino E Pesquisa Albert Einstein (IIEP), São Paulo, Brazil (Drs Cunha and Wolosker); and Departament of Physical education, Universidade Federal Rural de Pernambuco, Recife, Brazil (Dr Farah).
Purpose:
To analyze the acute cardiovascular responses to arm-cranking (AC) exercise in patients with peripheral artery disease (PAD), comparing it to walking and a nonexercise control condition.
Methods:
This study is a randomized crossover trial with single-blind data collection in which 17 patients with PAD and claudication (53% men, 66 ± 7 years old, 26.7 ± 4.4 kg/m 2 body mass index, 0.63 ± 0.12 ankle-brachial index) were included. They performed 3 experimental conditions (walking, AC, and control) in random order. The exercise conditions were composed of 15 bouts of 2 minutes (15 × 2) with an intensity equivalent to 4 to 6 on a modified (1-10) Borg Rating of Perceived Exertion scale. We measured blood pressure (BP), cerebral blood flow, heart rate variability, and brachial and femoral artery flow-mediated dilation before and after the conditions. Generalized estimated equations were used to analyze the acute response among experimental conditions, with P < .05 considered significant.
Results:
We observed post-exercise hypotension in both AC and walking, with a greater net effect in the AC condition compared with walking (systolic BP: AC = -14 ± 14 mm Hg; walking = -6.7 ± 8.9 mm Hg, P < .001; diastolic BP: AC = -5.8 ± 8.4 mm Hg; walking = -1.2 ± 4.1 mm Hg, P = .011). Brachial and femoral artery flow-mediated dilation, cerebral blood flow, and heart rate variability did not change after any of the conditions.
Conclusion:
Vascular function, cerebral blood flow, and heart rate variability remained unchanged after AC and walking. However, both walking and AC induced post-exercise hypotension in patients with PAD, with a greater magnitude in the AC condition.
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