Step It Up for Healthy Arteries

Peripheral artery disease (PAD)—also referred to as peripheral arterial disease, peripheral vascular disease (PVD), and peripheral artery occlusive disease (PAOD)—is a condition in which blood flow to the arms and legs is reduced due to narrowing of the arteries in these areas.

PAD decreases quality of life, makes simple everyday activities more difficult, and can lead to severe leg pain after walking short distances (intermittent claudication). New research now provides hope that even for people with PAD, exercise will improve health and function.

“PAD”ing toward better health

For this study, 156 people with PAD, with and without intermittent claudication, were randomly selected for one of the following groups:

• Control group, which received 11, one-hour nutritional sessions over 24 weeks, covering nutritional supplements, healthful restaurant eating, and eating more fruit and vegetables.
  
  
• Supervised treadmill exercise group, consisting of three sessions per week for 24 weeks, of increasing intensity over time, beginning with 15 minutes and increasing to 40 minutes per session.
  
  
• Supervised lower extremity resistance training, consisting of three sessions per week for 24 weeks. Participants completed three sets of eight repetitions on knee extension, leg press, and leg curl weight machines and increased resistance (weight) over time. Squats and toe rises (“standing on tip toe”) also were part of the program.

After 24 weeks, relative to the control group:

• The treadmill group significantly increased distance covered in a 6-minute walking test, improved their arterial blood flow, increased maximal treadmill walking time, and improved their quality of life.
  
  
• The resistance exercise group significantly improved functional performance as measured by a walking impairment score, improved their stair climbing ability, and improved their quality of life.

More than just fitness

This research suggests that even after PAD has developed, exercise can improve more than just fitness. It can improve your quality of life, which is what it’s really all about—living better! The following tips will get you on your way to improved health, even if you already have PAD:

• Before you begin any exercise program, check with your doctor to get the okay that this is safe for you. This is especially important if you have PAD, which can signal that you also have more widespread cardiovascular disease.
  
  
• Exercising to better manage PAD will improve your heart health and your overall well-being as well, which are great motivators to stick with it.
  
  
• Readjust your idea of “exercise.” You do not need to run a marathon. Study participants exercised by walking 15 to 40 minutes per day, or by engaging in a moderate strength-training program.
  
  
• For best benefit, you may want to obtain permission from your doctor to combine a walking and strength-training program.
  
  
• For a program tailored to meet your specific needs, ask your doctor for a referral to a physical therapist or exercise physiologist who specializes in working with people who have PAD or other forms of cardiovascular disease.

(JAMA 2009;301:165-74)

July 9, 2009

Suzanne Dixon, MPH, MS, RD, an author, speaker, and internationally recognized expert in chronic disease prevention, epidemiology, and nutrition, has taught medical, nursing, public health, and alternative medicine coursework. She has delivered over 150 invited lectures to health professionals and consumers and is the creator of a nutrition website acclaimed by the New York Times and Time magazine. Suzanne received her training in epidemiology and nutrition at the University of Michigan, School of Public Health at Ann Arbor.

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