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The Effect of Exercise Modalities on Walking Capacity in Patients With Intermittent Claudication: A NETWORK META-ANALYSIS.

Journal of cardiopulmonary rehabilitation and prevention
January 1, 1970
Renaud Tremblay et al. (9 authors)
Journal ArticleResearch Support, Non-U.S. Gov'tNetwork Meta-AnalysisHuman Study
Study Details

Study Goal

The researchers aimed to compare the effects of different supervised exercise therapies on walking capacity in patients with symptomatic peripheral arterial disease (PAD).

Results Summary

Combined training showed comparable improvement in treadmill walking capacity to aerobic walking but with a larger effect size. Underwater training and aerobic walking also improved walking capacity, though combined training was the most promising modality.

Population

Patients with symptomatic peripheral arterial disease (PAD).

Effective Dosage

Not specified (interventions included aerobic exercise, resistance training, combined training, and underwater exercise).

Duration

6-24 weeks.

Interactions

None mentioned.

Extracted Claims (10)
InterventionDirectionEndpointPopulationDosageImpactClaim #
combined training
increase
treadmill walking capacity
patients with symptomatic PAD
+122.0 [24.2-219.8] m
improved
#1
aerobic walking
increase
treadmill walking capacity
patients with symptomatic PAD
+106.8 [34.2-179.4] m
improved
#2
combined training
increase
treadmill walking capacity
patients with symptomatic PAD
1.20 [0.50-1.90]
larger effect size
#3
aerobic walking
increase
treadmill walking capacity
patients with symptomatic PAD
0.67 [0.22-1.11]
effect size
#4
combined training
increase
6-min walk distance
patients with symptomatic PAD
+57.3 [16.2-98.5] m
most promising modality
#5
underwater training
increase
6-min walk distance
patients with symptomatic PAD
+56.5 [22.4-90.5] m
improved
#6
aerobic walking
increase
6-min walk distance
patients with symptomatic PAD
+39.0 [12.8-65.1] m
improved
#7
combined exercise
increase
walking capacity
patients with symptomatic PAD
-
most promising training modality
#8
aerobic walking
increase
walking capacity
patients with symptomatic PAD
-
improved
#9
underwater training
increase
walking capacity
patients with symptomatic PAD
-
improved
#10
Abstract

INTRODUCTION: Despite extensive research on the effect of supervised exercise therapy on walking performance in patients with symptomatic peripheral arterial disease (PAD), it remains unclear which training modality provides the greatest improvement in walking capacity. The objective of this study was to compare the effect of different types of supervised exercise therapy on walking capacity in individuals with symptomatic PAD. METHODS: A random-effect network meta-analysis was performed. The following databases were searched from January 1966 to April 2021: SPORTDiscus, CINAHL, MEDLINE, AMED, Academic Search Complete and, Scopus. Trials had to include at least one type of supervised exercise therapy for patients with symptomatic PAD, with an intervention lasting ≥2 wk with ≥5 training sessions, and an objective measure of walking capacity. RESULTS: Eighteen studies were included for a total sample of 1135 participants. Interventions duration ranged from 6-24 wk and included aerobic exercise (treadmill walking, ergometer, and Nordic walking), resistance training (lower and/or upper body), a combination of both, and underwater exercise. Results showed that combined training improved treadmill walking capacity to a comparable extent to aerobic walking (+122.0 [24.2-219.8] m vs +106.8 [34.2-179.4] m), but with a larger effect size (1.20 [0.50-1.90] vs 0.67 [0.22-1.11]). Similar results were observed for the 6-min walk distance, with combined training being the most promising modality (+57.3 [16.2-98.5] m), followed by underwater training (+56.5 [22.4-90.5] m) and aerobic walking (+39.0 [12.8-65.1] m). CONCLUSION: While not statistically superior to aerobic walking, combined exercise seems to be the most promising training modality. Aerobic walking and underwater training also improved walking capacity for patients with symptomatic PAD.

Medical Subject Headings (MeSH)
HumansIntermittent ClaudicationExerciseExercise TherapyPeripheral Arterial DiseaseWalkingTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality90/10
Citation Metrics
Total Citations3
Citations/Year1.5
Relative Citation Ratio0.79
NIH Percentile41.8%
Research Impact Scores
APT Score0.25
Weight Score1.64
Normalized Score0.72
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