Intensity-dependent effects of exercise therapy on walking performance and aerobic fitness in symptomatic patients with lower-extremity peripheral artery disease: A systematic review and meta-analysis.

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Version: author
License: CC BY-NC 4.0
Serval ID
serval:BIB_90B361CB5F56
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Intensity-dependent effects of exercise therapy on walking performance and aerobic fitness in symptomatic patients with lower-extremity peripheral artery disease: A systematic review and meta-analysis.
Journal
Vascular medicine
Author(s)
Fassora M., Calanca L., Jaques C., Mazzolai L., Kayser B., Lanzi S.
ISSN
1477-0377 (Electronic)
ISSN-L
1358-863X
Publication state
Published
Issued date
04/2022
Peer-reviewed
Oui
Volume
27
Number
2
Pages
158-170
Language
english
Notes
Publication types: Journal Article ; Meta-Analysis ; Systematic Review
Publication Status: ppublish
Abstract
We investigated how nonpain-based exercise therapy intensity (light-to-moderate or vigorous) affects improvements in walking performance and cardiorespiratory fitness of patients with symptomatic lower-extremity peripheral artery disease (PAD). We searched the Embase, MEDLINE, Cochrane, Web of Science, and Google Scholar databases up to April 2021 and included randomized controlled trials reporting training therapies targeting exercise intensity (heart rate, oxygen consumption, or perceived exertion). The main outcomes were walking performance (pain-free [PFWD] and maximal [MWD] walking distance) and cardiorespiratory fitness (V̇O <sub>2peak</sub> ). Secondary subanalyses examined the training modality (walking or other modalities) and the approach (high-intensity interval or moderate-intensity training). A total of 1132 patients were included. Light-to-moderate was superior to vigorous exercise intensity in improving MWD (223 m [95% CI 174 to 271], p < 0.00001; 153 m [95% CI 113 to 193], p < 0.00001; respectively) and PFWD (130 m [95% CI 87 to 173], p < 0.00001; 83 m [95% CI 61 to 104], p < 0.00001; respectively). When training modalities were considered, walking at a vigorous intensity (272 m [95% CI 207 to 337], p < 0.00001) showed the largest improvement in MWD compared to other exercise modalities. A larger increase in V̇O <sub>2peak</sub> was observed following vigorous (3.0 mL O <sub>2</sub> ·kg <sup>-1</sup> ·min <sup>-1</sup> [95% CI 2.4 to 3.6], p < 0.00001) compared to light-to-moderate (1.1 mL O <sub>2</sub> ·kg <sup>-1</sup> ·min <sup>-1</sup> [95% CI 0.4 to 1.7], p = 0.001) exercise intensity. These results indicate that vigorous was less effective than light-to-moderate intensity in improving walking performance, whereas it was more effective in improving V̇O <sub>2peak</sub> . When the training modalities were considered, walking at a vigorous intensity showed the greatest improvement in MWD. (PROSPERO Registration No.: CRD42020199469).
Keywords
Exercise Therapy/adverse effects, Exercise Therapy/methods, Humans, Intermittent Claudication/diagnosis, Intermittent Claudication/therapy, Lower Extremity, Peripheral Arterial Disease/diagnosis, Peripheral Arterial Disease/therapy, Walking, exercise therapy, high-intensity interval training, intermittent claudication, peripheral artery disease (PAD), vascular rehabilitation
Pubmed
Web of science
Open Access
Yes
Create date
04/10/2021 8:56
Last modification date
06/05/2022 5:34
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