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The Effect of Different Supervised Exercise Modalities on Cardiorespiratory Fitness in Patients With Peripheral
Cheng-Wei Ho1, Yan-Rong Ho, Min-Hsiang Chuang
1Author Affiliations: Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, Taiwan (Drs Cheng-Wei Ho and Chou); Department of General Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan (Dr Yan-Rong Ho); Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan (Dr Chuang); Department of Pharmacy, College of PharmaceuticalSciences, National Yang, Ming Chiao Tung University, Taipei, Taiwan (Ms Wu); and Department of Leisure and Sports Management, CTBC University, Tainan, Taiwan (Dr Chou).
Objective:
Supervised exercise is currently recognized as the first-line treatment for patients with peripheral artery disease. However, the comparative benefits of treadmill training, arm-ergometry, and leg-ergometry remain unclear.
Review Methods:
Medline, Embase, and the Cochrane Library were searched from inception to May 7, 2025, for randomized controlled trials in adults with peripheral artery disease. Eligible studies involved supervised treadmill, arm-ergometry, or leg-ergometry interventions lasting 12 to 24 weeks and compared these interventions with other exercise modalities or nonexercise controls. A frequentist random-effects network meta-analysis was conducted to estimate mean differences (MDs) with 95% CI for peak oxygen uptake, maximal walking distance, and pain-free walking distance.
Summary:
Eleven trials involving 519 participants were included. Arm-ergometry increased peak oxygen uptake by 1.85 mL/kg/min (95% CI, 0.99-2.71 mL/kg/min, P < .01), and treadmill training increased peak oxygen uptake by 1.46 mL/kg/min (95% CI, 1.12-1.81 mL/kg/min, P < .01) compared with control. Treadmill training increased maximal walking distance (MD = 191.25: 95% CI, 66.84-315.65 m, P < .01), whereas arm-ergometry showed no significant difference (MD = 121.35: 95% CI, -45.61 to 288.32 m, P = .15). In addition, pain-free walking distance improved with treadmill training (MD = 181.88: 95% CI, 154.99-208.76 m, P < .01), arm-ergometry (MD = 78.11: 95% CI, 54.62-101.60 m, P < .01), and leg-ergometry (MD = 51.08: 95% CI, 8.27-93.89 m, P = .02) compared with control.
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