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
Contact: Karen Blum
Johns Hopkins Medical Institutions