Effect of low intensity exercise training on circulatory and autonomic measures in patients with peripheral artery disease.
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The purpose of this study was to examine the effects of a progressive, low-intensity walking intervention on circulatory and autonomic adaptations in patients with peripheral arterial disease after controlling for potential confounders such as age, sex, ß-blockers and smoking. Secondary objectives were 1) to determine the effect of the intervention on walking performance and self-report measures and 2) to determine if there were any sex-specific differences that might exist at rest or in response to training. Forty-eight participants (aged 67.81 ± 8.13 years, mean ± standard deviation) with intermittent claudication (ankle-brachial index 0.54 ± 0.18) were randomly assigned to either a walking group (n = 27) who performed a structured walking program, 5 days per week for 12 weeks, or a comparison group (n = 21) who performed usual activities. Thirty-three (69%) participants (15 comparison group members and 18 walking group members) completed the study. Circulatory measures (ankle-brachial index, heart rate, blood pressure, mean arterial pressure and rate pressure product), autonomic measures (heart rate variability, low frequency power, high frequency power, total power, parasympathetic nervous system indicator and sympathetic nervous system indicator), tests of walking performance (pain-free, functional and maximal walking distance as well as the 6 minute walk test) and self-report measures (the Walking Impairment Questionnaire and Quality of Life Questionnaire were obtained at the beginning (Week 1) and end (Week 12) of the study. Autonomic function (heart rate variability) improved and overall walking performance increased in members of the walking group. Men and women responded similarly to the training program. These findings suggest that a structured, low-intensity, high frequency walking program is effective in improving HRV, increasing walking performance and daily walking distance.