Treadmill Exercise and Resistance Training in Patients With Peripheral Arterial Disease With and Without Intermittent Claudication: A Randomized Controlled Trial
Open accessAbstract
CONTEXT: Neither supervised treadmill exercise nor strength training for patients with peripheral arterial disease (PAD) without intermittent claudication have been established as beneficial. OBJECTIVE: To determine whether supervised treadmill exercise or lower extremity resistance training improve functional performance of patients with PAD with or without claudication. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled clinical trial performed at an urban academic medical center between April 1, 2004, and August 8, 2008, involving 156 patients with PAD who were randomly assigned to supervised treadmill exercise, to lower extremity resistance training, or to a control group. MAIN OUTCOME MEASURES: Six-minute walk performance and the short physical performance battery. Secondary outcomes were brachial artery flow-mediated dilation, treadmill walking performance, the Walking Impairment Questionnaire, and the 36-Item Short Form Health Survey physical functioning (SF-36 PF) score. RESULTS: For the 6-minute walk, those in the supervised treadmill exercise group increased their distance walked by 35.9 m (95% confidence interval [CI], 15.3-56.5 m; P < .001) compared with the control group, whereas those in the resistance training group increased their distance walked by 12.4 m (95% CI, -8.42 to 33.3 m; P = .24) compared with the control group. Neither exercise group improved its short physical performance battery scores. For brachial artery flow-mediated dilation, those in the treadmill group had a mean improvement of 1.53% (95% CI, 0.35%-2.70%; P = .02) compared with the control group. The treadmill group had greater increases in maximal treadmill walking time (3.44 minutes; 95% CI, 2.05-4.84 minutes; P < .001); walking impairment distance score (10.7; 95% CI, 1.56-19.9; P = .02); and SF-36 PF score (7.5; 95% CI, 0.00-15.0; P = .02) than the control group. The resistance training group had greater increases in maximal treadmill walking time (1.90 minutes; 95% CI, 0.49-3.31 minutes; P = .009); walking impairment scores for distance (6.92; 95% CI, 1.07-12.8; P = .02) and stair climbing (10.4; 95% CI, 0.00-20.8; P = .03); and SF-36 PF score (7.5; 95% CI, 0.0-15.0; P = .04) than the control group. CONCLUSIONS: Supervised treadmill training improved 6-minute walk performance, treadmill walking performance, brachial artery flow-mediated dilation, and quality of life but did not improve the short physical performance battery scores of PAD participants with and without intermittent claudication. Lower extremity resistance training improved functional performance measured by treadmill walking, quality of life, and stair climbing ability. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00106327.
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Lower extremity resistance training improves functional performance measured by treadmill walking, stair climbing ability, and QOL measures.
“Lower extremity resistance training also improves functional performance measured by treadmill walking, stair climbing ability, and QOL measures ( 187 ).”
From Exercise and Type 2 Diabetes (2010) · cites this paper as [187]
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- Authors
- McDermott, M. M., Ades, P., Guralnik, J. M., Dyer, A., Ferrucci, L., Liu, K., Nelson, M., Lloyd-Jones, D., Van Horn, L., Garside, D., Kibbe, M., Domanchuk, K., Stein, J. H., Liao, Y., Tao, H., Green, D., Pearce, W. H., Schneider, J. R., McPherson, D., Laing, S. T., McCarthy, W. J., Shroff, A., & Criqui, M. H.
- Affiliations
- Northwestern University (US)
- University of Vermont (US)
- National Institute on Aging (US)
- Tufts University (US)
- University of Wisconsin–Madison (US)
- The University of Texas Health Science Center at Houston (US)
- Rush University Medical Center (US)
- University of Illinois Urbana-Champaign (US)
- University of California San Diego (US)
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2009-01-14
- Volume
- 301
- Issue
- 2
- Pages
- 165
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC3268032
- OpenAlex
- W1990603543
- Cited by
- 449
- References
- 51
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 16 · 2023: 20 · 2022: 22 · 2021: 26 · 2020: 19 · 2019: 26 · 2018: 20 · 2017: 31 · 2016: 25 · 2015: 21 · 2014: 35 · 2013: 38 · 2012: 34
- FWCI
- 41.13
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (Z01AG001050)
- National Heart, Lung, and Blood Institute (R01-HL073551, R44HL073551, R43HL073551)
- National Center for Research Resources (RR00048, M01RR000048)
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- peripheral arterial disease, intermittent claudication, treadmill exercise, resistance training, supervised exercise therapy, functional performance, 6-minute walk test, Short Physical Performance Battery, flow-mediated dilation, gait disturbance, physical function
- MeSH terms
- Aged, Exercise Therapy, Female, Humans, Intermittent Claudication, Male, Middle Aged, Physical Fitness, Quality of Life, Walking, Peripheral Vascular Diseases, Lower Extremity, Resistance Training, Ankle Brachial Index
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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