Exercise Test and Sequential Training Strategies in PAD
Exercise Test and Sequential Training Strategies in Peripheral Arterial Disease
Diabetic lower extremity disease, including peripheral vascular disease, peripheral neuropathy, foot ulcers, or leg amputation. Among them, peripheral arterial disease (PAD) is an important expression of systemic atherosclerosis. With the progress of the disease, impaired peripheral blood circulation will lead to many symptoms and signs, such as pain, paresthesia, and numbness.
In past studies show that regular exercise with moderate intensity may help to improve metabolism and hemodynamic characteristics of the individual. In addition, many studies have found that despite substantial organic changes in downstream tissue, exercise training can improve walking ability and aerobic capacity in patients with peripheral arterial disease.
To enhance exercise capacity in patients with PAD may involve redistribution of blood flow from vascular beds with lower O 2 exchange rates towards exercising ischemic muscles, an increase in nutritive leg muscle blood flow at the expense of regional shunting mechanisms, increased peripheral O 2 use during exercise attributable to more optimal distribution of leg blood flow, and possible increased muscle capillary density and mitochondrial capacity.
Therefore, we tried to mimic local (leg) ischemic- reperfusion by systemic exercise, or to practice remote preconditioning effect by interval occlusion of the blood vessel in the upper arm which acquired ischemic preconditioning effect, and to improve local blood flow. Furthermore, the hemagglutination performance in PAD patients may also be used as an important indicator of cardiovascular disease.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Diabetic lower extremity disease, including peripheral vascular disease, peripheral neuropathy, foot ulcers, or leg amputation. Among them, peripheral arterial disease (PAD) is an important expression of systemic atherosclerosis. With the progress of the disease, impaired peripheral blood circulation will lead to many symptoms and signs, such as pain, paresthesia, and numbness.
In past studies show that regular exercise with moderate intensity may help to improve metabolism and hemodynamic characteristics of the individual. In addition, many studies have found that despite substantial organic changes in downstream tissue, exercise training can improve walking ability and aerobic capacity in patients with peripheral arterial disease.
To enhance exercise capacity in patients with PAD may involve redistribution of blood flow from vascular beds with lower O 2 exchange rates towards exercising ischemic muscles, an increase in nutritive leg muscle blood flow at the expense of regional shunting mechanisms, increased peripheral O 2 use during exercise attributable to more optimal distribution of leg blood flow, and possible increased muscle capillary density and mitochondrial capacity.
Therefore, we tried to mimic local (leg) ischemic- reperfusion by systemic exercise, or to practice remote preconditioning effect by interval occlusion of the blood vessel in the upper arm which acquired ischemic preconditioning effect, and to improve local blood flow. Furthermore, the hemagglutination performance in PAD patients may also be used as an important indicator of cardiovascular disease
Type d'étude
Inscription (Anticipé)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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Keelung, Taïwan, 204
- Recrutement
- Department of Physical Medicine and Rehabilitation of Keelung Chang Gung Memorial hospital
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Contact:
- Tieh Cheng Fu, MD, PhD
- Numéro de téléphone: 2626 886-2-24313131
- E-mail: mr5598@adm.cgmh.org.tw
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Chercheur principal:
- Tieh-Cheng Fu, MD
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Ankle-brachial index <0.9
Exclusion Criteria:
1.<20 years old 2. There are other diseases or behavioral restrictions that prevent exercise training 3. Other exercise contraindications:
- unstable angina
- resting systolic blood pressure greater than 200 mmHg or diastolic blood pressure greater than 110 mmHg
- orthostatic blood pressure drop greater than 20 mmHg with symptoms
- Symptomatic severe aortic stenosis
- Acute systemic infection, accompanied by fever, body aches, or swollen lymph glands
- Uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise
- Uncontrolled symptomatic heart failure
- High-degree atrioventricular blocks
- Acute myocarditis or pericarditis
- Acute pulmonary embolus or pulmonary infarction
- a recent significant change in the resting electrocardiogram suggesting significant ischemia,
- recent myocardial infarction (within 2 d), or other acute cardiac events
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Comparateur actif: usual training
exercise intensity arranged by cardiopulmonary exercise test results
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We adjust exercise intensity by the oxygen saturation change show in near-infrared spectrometer
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Expérimental: Novel exercise training
exercise intensity monitor by near-infrared spectrometer
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We adjust exercise intensity by the oxygen saturation change show in near-infrared spectrometer
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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physical fitness (peak oxygen consumption)
Délai: after 36 session exercise training, up to 12 weeks
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oxygen consumption in cc/min/kg measured by Carefusion(TM) during cardiopulmonary exercise test
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after 36 session exercise training, up to 12 weeks
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physical fitness (exercise duration)
Délai: after 36 session exercise training, up to 12 weeks
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exercise duration in seconds measured during cardiopulmonary exercise test
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after 36 session exercise training, up to 12 weeks
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physical fitness (walking distance)
Délai: after 36 session exercise training, up to 12 weeks
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walking distance in meters measured during six minutes walking test
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after 36 session exercise training, up to 12 weeks
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Collaborateurs et enquêteurs
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Anticipé)
Achèvement de l'étude (Anticipé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 103-4837B
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
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