The Effect of Exercise Modalities on Walking Capacity in Patients With Intermittent Claudication: A NETWORK META-ANALYSIS.
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.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.