Abstract
Atherosclerosis is a progressive, generalized disease affecting the entire arterial system. The development of atherosclerotic lesions in the large arteries of the lower extremities eventually leads to significant stenosis. Consequently, blood flow distal to the lesions is significantly impaired. The condition is referred to as lower extremity arterial disease (LEAD).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Zatina MA, Berkowitz HD, Gross GM, Marts JM, Chance B. 31P nuclear magnetic resonance spectroscopy: Noninvasive biomechanical analysis of the ischemic extremity. J Vase Surg 1986;3:411–420.
Holm S, Bylund-Fellenius AC. Continuous monitoring of oxygen tension in human gastrocnemius muscle during exercise. Clin Physiol 1981;1:541–552.
Ekroth R, Dahllof A-G, Gundevall B, Holm J, Schersten T. Physical training of patients with intermittent claudication: Indications, methods, and results. Surgery 1978;84:640–643.
Regensteiner JG, Steiner JF, Panzer RJ, Hiatt WR. Evaluation of walking impairment by questionnaire in patients with peripheral arterial disease. J Vase Med Biol 1990;2:142–152.
Porter JM, Cutler BS, Lee BY, Reich T, Reichle FA, Scorgin JT, Strandness DE. Pentoxifylline efficacy in the treatment of intermittent claudication: Multicenter controlled double-blind trial with objective assessment of chronic occlusive arterial disease patients. Am Heart J 1982;104:66–72.
Brevetti G, Perna S, Sabba C, Rossini A, Scotto di Uccio V, Berardi E, Godi L. Superiority of L-propionyl carnitine vs L-carnitine in improving walking capacity in patients with peripheral vascular disease: An acute, intravenous, double-blind, cross-over study. Eur Heart J 1992;13:251–255.
NIH Consensus Development Panel on Physical Activity and Cardiovascular Health. Physical activity and cardiovascular health. JAMA 1996;276:241–246.
Manson JE, Greenland, P, LaCroix AZ, et al. Walking compared with vigorous exercise for the prevention of cardiovascular events in women. N Engl J Med 2002;347(10):716–725.
Tuomilehto J, Lindstrom J, Eriksson J, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344:1343–1350.
Myers J, Prakash M, Froelicher V, Partington S, Atwood E. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 2002;346:793–801.
Tanasescu M, Leitzmann MF, Rimm EB, Hu, FB. Physical activity in relation to cardiovascular disease and total mortality among men with type 2 diabetes. Circulation 2003;107:2435–2439.
Diabetes Prevention Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393–403.
Kokkinos P, Narayan P, Papademetriou V. “Exercise as Hypertension Therapy” Cardiology Clinics 2001; 19:507–516.
Kokkinos P, Fernhall B. Physical activity and high density lipoprotein cholesterol levels: What is the relationship? Sports Medicine 1999;28950:307–314.
Pate RR, Pratt M, Blair SN. Physical activity and public health: A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995;273:402–407.
American College of Sports Medicine. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc 1998;30:975–991.
Fletcher GF, Balady G, Amsterdam EA, et al. Exercise standards for testing and training: A statement for healthcare professionals from the American Heart Association. Circulation 2001;104:1694–1740.
Hillestad LK. The peripheral blood flow in intermittent claudication. IV. Significance of the claudication distance. Acta Med Scand 1963;173:467–478.
Larsen OA, Lassen NA. Effect of daily muscular exercise in patients with intermittent claudication. Lancet 1966;2:1093–1095.
Skinner JS, Strandness, DE. Exercise and intermittent claudication. Circulation 1967;36:23–29.
Alpert JS, Larsen A, Lassen NA. Exercise and intermittent claudication: Blood flow in the calf muscle during walking studied by the Xenon-133 method. Circulation 1969;S9:353–359.
Gardner AW. Exercise training for patients with peripheral arterial disease. In: Thompson PD, eds. Exercise and Sports Cardiology. McGraw-Hill Medical Publishing Division, 2001, pp. 371–401.
Gardner AW, Poehlman ET. Exercise rehabilitation programs for the treatment of claudication pain: A meta-analysis. JAMA 1995;274:975–980.
Carter SA, Hamel ER, Paterson JM, Snow CJ, Mymin D. Walking ability and ankle systolic pressures: observations in patients with intermittent claudication in a short-term walking exercise program. J Vase Surg 1989;10:642–649.
Dahllof A-G, Bjorntorp P, Holm J, Schersten T. Metabolic activity of skeletal muscle in patients with peripheral arterial insufficiency. Eur J Clin Invest 1974;4:9–15.
Dahllof A-G, Holm J, Schersten T, Sivertsson R. Peripheral arterial insufficiency: Effect of physical training on walking tolerance, calf blood flow, and blood flow resistance. Scand J Rehab Med 1976;8:19–26.
Ericsson B, Haeger K, Lindell SE. Effect of physical training on intermittent claudication. Angiology 1970;21:188–192.
Ernst EE, Matrai A. Intermittent claudication, exercise, and blood rheology. Circulation 1987;16:1110–1114.
Feinburg RL, Gregory RT, Wheeler JR, Snyder SO, Gayle RG, Parent FN, Patterson RB. The ischemic window: A method for the objective quantication of the training effect in exercise therapy for intermittent claudication. J Vase Surg 1992;16:244–250.
Hiatt WR, Regensteiner JG, Hargarten ME, Wolfel EE, Brass EP. Benefit of exercise conditioning for patients with peripheral arterial disease. Circulation 1990;81:602–609.
Hiatt WR, Wolfel EE, Meier RH, Rengensteiner JG. Superiority of treadmill walking exercise vs strength training for patients with peripheral arterial disease. Circulation 1994;90:1866–1874.
Holm J, Dahllof A-G, Bjorntorp P, Schersten T. Enzyme studies in muscles of patients with intermittent claudication: Effect of training. Scand J Clin Lab Invest 1973;S128:201–205.
Jonason T, Ringqvist I. Effect of training on post-exercise ankle blood pressure reaction in patients with intermittent claudication. Clin Physiol 1987;7:63–69.
Lepantalo M, Sundberg S, Gordin A. The effects of physical training and flunarizine on walking capacity in intermittent claudication. ScandJ Rehab Med 1984;16:159–162.
Lundgren F, Dahllof A-G, Lundholm K, Schersten T, Volkmann R. Intermittent claudication-surgical reconstruction or physical training? Ann Surg 1989; 209:346–355.
Lundgren F, Dahllof A-G, Schersten T, Bylund-Fellenius AC. Muscle enzyme adaptation in patients with peripheral arterial insufficiency: Spontaneous adaptation, effect of different treatments and consequences on walking performance. Clin Sci 1989;77:485–493.
Mannarino E, Pasqualini L, Innoncente S, Scricciolo V, Rignanese A, Ciuffetti G. Physical training and antiplatelet treatment in stage II peripheral arterial occlusive disease: Alone or combined? Angiology 1991;42:513–521.
Regensteiner JG, Steiner JF, Hiatt WR. Exercise training improves functional status in patients with peripheral arterial disease. J Vase Surg 1996;23:104–115.
Regensteiner JG, Meyer TJ, Krupski WC, Cranford LS, Hiatt WR. Hospital vs home-based exercise rehabilitation for patients with peripheral arterial occlusive disease. Angiology 1997;48:291–300.
Ruell PA, Imperial ES, Bonar FJ, et al. The effect of physical training on walking tolerance and venous lactate concentration. EurJ Appl Physiol 1984;52:420.
Frontera WR, Meredith CN, O’Reilly KP, Evans WJ. Strength training and determinants of VO2max in older men. J Appl Physiol 1990;68:329–333.
Braith RW, Vincent KR. Resistance exercise in the elderly person with cardiovascular disease. Am J Geriatr Cardiol 1999;8:63–79.
Flegg JL, Lakatta, EG. Role of muscle loss in the age-related associated reduction in VO2max. J Appl Physiol 1988;65:1147–1151.
Regensteiner JG, Wolfel EE, Brass EP, Carry MR, et al. Chronic changes in skeletal muscle histology and function in peripheral arterial disease. Circulation 1993;87:413–421.
Vincent KR, Braith RW, Feldman RA, Kallas, HE, Lowenthal DT. Improved car-diorespiratory endurance following 6 months of resistance exercise in elderly men and women. Arch Intern Med 2002;162:673–678.
Karlsson JB, Sjodin B, Thorstensson A, Hulten B, Frith K. LDH isozymes in skeletal muscles of endurance and strength trained athletes. Ada Physiol Scand 1975;93:150–156.
Ainsworth BE, Haskell, WL, Leon AS, Jacobs, DR, Montoye HJ, Sallis JF, Paffenbarger RS. Compendium of physical activities: Classification of energy costs of human physical activities. Med Sci Sports Exer 1993;25:71–80.
Gardner AW, Skinner JS, Smith LK. Effects of handrail support on claudication and hemodynamic responses to a single-stage and progressive treadmill protocols in peripheral vascular occlusive disease. Am J Cardiol 1991;68:99–105.
Gardner AW, Skinner JS, Cantwell BW, Smith LK. Progressive vs single-stage treadmill tests for evaluation of claudication. Med Sci Sports Exerc 1991;23:402–408.
Hiatt WR, Regensteiner JG, Hargarten ME, Hossack KF. The evaluation of exercise performance in patients with peripheral vascular disease. J Cardiopulmonary Rehab 1988;12:525–532.
Green S, Mehlsen J. Peripheral Arterial Disease. In Saltin B, Boushel R, Secher N, Mitchel J, eds. Exercise and Circulation in Health and Disease. Champaign Il., Human Kinetics, 2000, pp. 283–290.
Blomqvist CG, Saltin B. Cardiovascular adaptations to physical training. Ann Rev Physiol 1983;45:169–189.
Holloszy JO, Coyle EF. Adaptations of skeletal muscle to endurance exercise and their metabolic consequences. JAppl Physiol 1984;56:831.
Holloszy JO. Metabolic consequences of endurance exercise training. In: Horton ES, Terjung RL, eds. Exercise, nutrition, and energy metabolism. New York: Macmillan, 1988, pp. 116–131.
Womack CJ, Sieminski DJ, Katzel LI, et al. Improved walking economy in patients with peripheral arterial occlusive disease. Med Sci Sports Exerc 1997;29:1286.
Albert C, Mittelman M, Chae C, et al. Triggering of sudden death from cardiac causes by vigorous exertion. New Engl J Med 2000;343:1355–1361.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Humana Press Inc., Totowa, NJ
About this chapter
Cite this chapter
Kokkinos, P.F. (2005). Exercise Therapy for Lower Extremity Arterial Disease. In: Caralis, D.G., Bakris, G.L. (eds) Lower Extremity Arterial Disease. Clinical Hypertension and Vascular Diseases. Humana Press. https://doi.org/10.1385/1-59259-881-1:243
Download citation
DOI: https://doi.org/10.1385/1-59259-881-1:243
Publisher Name: Humana Press
Print ISBN: 978-1-58829-554-5
Online ISBN: 978-1-59259-881-6
eBook Packages: MedicineMedicine (R0)