No pain, no gain in exercise for this common artery disease

In a new study from Northwestern Medicine, researchers found that no pain means no gain when it comes to reaping exercise benefits for people with peripheral artery disease (PAD).

They found in people with peripheral artery disease, walking for exercise at an intensity that induces ischemic leg pain (caused by restricted blood flow) improves walking performance.

Walking at a slow pace that does not induce ischemic leg symptoms is no more effective than no exercise at all.

About 8.5 million in the United States and about 250 million people worldwide have lower extremity peripheral artery disease (PAD). People with PAD have blockages in their arteries that slow or stop the blood flood flow to their legs.

As a result, they have pain and difficulty walking even short distances. It is comparable to angina for people who have symptomatic heart disease. Few therapies exist to treat it.

In the study, 305 people with peripheral artery disease were assigned to high-intensity exercise, low-intensity exercise, or a control group that got telephone calls that were not about exercise.

The team found patients who participated in high-intensity walking exercises strongly improved the distance they could walk in six minutes compared to either the low-intensity group or the control group.

The high-intensity exercise group also strongly improved the length of time they could walk on the treadmill at the end of the study, compared to each of the other two groups.

The team says patients with PAD should be advised to walk for exercise at a pace that induces ischemic leg symptoms in order to get a benefit.

Exercise is the most effective non-invasive therapy to improve walking in people with PAD.

The next step in the research is to determine the biological explanation for the finding that ischemia of the lower extremities appears necessary to gain benefit from walking exercise in people with PAD.

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The study is published in JAMA. One author of the study is Dr. Mary McDermott.

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