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Supervised exercise program is an effective remedy for cramping leg pain

A review of scores of studies testing the benefits of exercise in people with cramping leg pain, the most common symptom of peripheral arterial disease (PAD), suggests that regular walking while painful is worth it. The Johns Hopkins-led team of scientists published their report in the Dec. 12 issue of The New England Journal of Medicine.

PAD, a condition that affects eight to 10 million adults, and 5 percent of people ages 50 and up, is a form of atherosclerosis that affects the blood vessels of the legs. The buildup of cholesterol-laden plaque, similar to that which occurs in the arteries of the heart, reduces blood flow to the legs over time. The limited blood flow can't meet extra demand from the legs during walking or other exercise, resulting in pain, aching and fatigue.

"Unlike coronary artery disease patients, who should stop exercising as soon as they experience chest pain, PAD patients with cramping pain, called claudication, should walk until they reach a moderate level of leg pain and then continue for several minutes," says Kerry J. Stewart, Ed.D., Hopkins' director of clinical exercise physiology and lead author of the study. "After a few minutes of rest, the walking should be resumed, and this cycle should be repeated until the person can walk for 50 minutes. A supervised exercise program in which patients walk on a treadmill several times a week may be the best way to eventually ease the pain."

Stewart and colleagues at the Universities of Colorado and Minnesota reviewed more than 120 studies to reach their conclusions about exercise and PAD. Because patients with claudication experience pain when they exercise, they often slack off, Stewart says.

"As a result, many are so unfit they become housebound or dependent on others," he says. "In a gym setting such as a cardiac rehabilitation program, with staff monitoring and encouraging them, they're more likely to keep it up. The rewards are obvious
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Contact: Karen Blum
kblum@jhmi.edu
410-955-1534
Johns Hopkins Medical Institutions
11-Dec-2002


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