Birkett ST, Sinclair J, Seed SA, Pymer S, Caldow E, Ingle L, Harwood AE, Egun A. Effects of exercise prescribed at different levels of claudication pain on walking performance in patients with intermittent claudication: a protocol for a randomised controlled trial.
Ther Adv Cardiovasc Dis 2022;
16:17539447221108817. [PMID:
35762773 PMCID:
PMC9243571 DOI:
10.1177/17539447221108817]
[Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background:
Peripheral artery disease affects over 236 million people globally and the
classic symptom is intermittent claudication (IC) which is associated with
reduction in physical activity. The evidence that supervised exercise
programmes (SEPs) improve pain-free and maximal walking distance is
irrefutable. However, adherence rates are low with exercise-related pain
cited as a contributing factor. National and international guidelines
recommend exercising at a moderate to maximal level of claudication pain to
improve walking ability; however, exercising pain-free or at mild
claudication pain has been shown to achieve this outcome. There is limited
evidence that compares the relative effects of exercise prescribed at
different levels of claudication pain.
Objective:
The objective of this study is to directly compare the effects of exercise
prescribed at three different levels of claudication pain on walking
performance.
Design:
This study will be a single-centre randomised controlled trial.
Methods:
Based on an a priori power calculation, 51 patients with IC
will be allocated to 24 weeks of twice-weekly pain-free (PF), moderate pain
(MOD-P) or maximal pain (MAX-P) exercise. The PF group will cease exercise
at the onset of claudication (1 on the 0–4 IC rating scale), the MOD-P group
will stop once moderate pain is reached (2 on the rating scale) and the
MAX-P group will stop once maximal pain is reached (4 on the rating
scale).
Analysis:
Outcome measures will be assessed at baseline, 12 and 24 weeks adopting an
analysis of covariance (ANCOVA) to compare MWD across three time points. The
primary outcome for the trial will be change in maximal treadmill walking
distance at 12 and 24 weeks.
Registration:
Trial registration number: NCT04370327.
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