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High-Intensity Progressive Resistance Training Improves Flat-Ground Walking in Older Adults with Symptomatic Peripheral Arterial Disease

Authors

  • Belinda J. Parmenter PhD,

    Corresponding author
    1. Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
    2. Exercise Physiology Unit, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
    • Address correspondence to Belinda J. Parmenter, Exercise Physiology Unit, School of Medical Sciences, Faculty of Medicine, University of New South Wales, NSW, Australia 2052. E-mail: b.parmenter@unsw.edu.au

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  • Jacqueline Raymond PhD,

    1. Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
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  • Paul Dinnen MD,

    1. Gold Coast Vascular Centre, Ashmore, Queensland, Australia
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  • Robert J. Lusby MD,

    1. Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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  • Maria A. Fiatarone Singh MD

    1. Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
    2. Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
    3. Hebrew SeniorLife, and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
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Abstract

Objectives

To assess the efficacy of whole-body progressive resistance training (PRT) as a treatment for the symptoms of peripheral arterial disease (PAD) in older adults.

Design

Randomized controlled pilot trial.

Setting

University clinical weight training facility in Sydney, Australia.

Participants

Twenty-two older adults with symptomatic PAD.

Interventions

The efficacy of supervised whole-body high-intensity PRT (H-PRT) with low-intensity nonprogressive resistance training (L-RT) and a usual care control group that performed unsupervised walking for 6 months was compared.

Measurements

Pilot outcome measures included 6-minute walk (6 MW) outcomes, body composition, dynamic muscle strength and endurance, and performance-based tests of function.

Results

Mean age was 71.1 ± 7.2. Mean ankle brachial index was 0.55 ± 0.13. Exercise adherence was similar in all groups (P = .29). H-PRT (n = 8) improved total 6MW distance (mean difference (MD) 62.6 ± 58.0 m, P = .02) significantly more than L-RT (n = 7; MD=−48.2 ± 67.6 m) and controls (n = 7; MD=−9.9 ± 52.9 m). Change in 6MW onset of claudication was significantly and independently related to change in bilateral calf endurance (correlation coefficient (r) = 0.65, P = .03), and change in 6MW distance was significantly and independently related to change in bilateral hip extensor endurance (r = 0.71, P = .02) in all groups.

Conclusion

H-PRT significantly improved 6MW ability in older adults with intermittent claudication from PAD, whereas L-RT and unsupervised walking did not. Improvement in walking ability was significantly related to improvements in bilateral calf and hip extensor endurance, supporting further investigations targeted at musculoskeletal impairment in this cohort.

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