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Exercise - the new medicine for patients undergoing vascular surgery?
Conference presentation

Exercise - the new medicine for patients undergoing vascular surgery?

Christopher D Askew
USC Research Conference, 2013 (Sunshine Coast, Australia, 01-Jul-2013–05-Jul-2013)
University of the Sunshine Coast
2013
url
https://www.usc.edu.au/View
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Abstract

Human Movement and Sports Science exercise vascular surgery peripheral arterial disease
Background: Peripheral arterial disease (PAD) is characterised by blockages in the arteries of the lower limbs. Although supervised exercise training is recommended for patients with early-stage PAD, the effects of exercise training in patients who have undergone surgery (revascularisation) for their condition are not clear. This study aimed to determine the effect of post-revascularisation exercise training on walking tolerance, muscle fatigue and lower limb blood flow in patients with PAD. Methods: Fifteen patients who had recently (<6 weeks) undergone revascularisation for PAD were randomised to either supervised exercise training (SET: n = 8, age = 61+/-6 y) or standard care (CON: n=7, age = 65+/-10 y). Patients in SET attended three training sessions per week for six weeks, and completed interval treadmill walking and progressive leg resistance exercises. Before and after the intervention period, walking capacity was determined with a six-minute walk test. Muscle strength, endurance, and fatigue of the calf muscles were assessed using an isometric plantar flexion dynamometer. Blood flow was assessed at rest and during exercise using strain gauge plethysmography. Results: Six-minute walk distance increased with SET (pre 405 +/- 89; post 452 +/- 94 m) compared with CON (pre 412 +/- 67; post 413 +/- 79 m). Plantar flexion MVC force tended to increase with SET in both the revascularised (~11%) and non-revascularised legs (~15%), although this was only significant compared with CON in the non-revascularised leg. Plantar flexion endurance increased with SET in both the revascularised (pre 541 +/- 318; post 1108 +/- 909 s) and non-revascularised legs (pre 623 +/- 319; post 1143 +/- 556 s) compared with CON. There tended to be a slowing of the rate of fatigue following SET. There were no changes in resting or exercise blood flow in either group. Discussion: This study demonstrates that supervised exercise improves walking capacity and calf muscle function in patients with PAD who have recently undergone revascularisation. These changes occurred in the absence of any change in blood flow, which supports the notion that exercise tolerance is not only limited by blood flow PAD.

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