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Walking training in intermittent claudication: responses at rest and after maximal exercise

Abstract

Patients with intermittent claudication (IC) present reduced walking capacity and high cardiovascular risk. Both of these repercussions of the disease might be, at least in part, related to the presence of processes such as autonomic dysfunction, inflammation, oxidative stress and reduced nitric oxide (NO) availability that are common in these patients. Walking training (WT) increases walking capacity and may decrease cardiovascular risk in IC, and some studies suggest positive effects of WT on the processes previously exposed. However, the results that support this issue, besides being scarce and controversial, are limited to blood measurements which included local responses, directly produced in the muscle affected by the disease (lower limb) that are submitted to ischemic/reperfusion cycles during walking, as well as systemic responses, produced by exercise in non-affected arteries. Thus, by doing measurements only in blood it is not possible to specific identify responses of the affected muscle neither to balance between the local and systemic responses. In a previous study (FAPESP funding), we designed a specific WT protocol for patients with IC that improved walking capacity and cardiovascular regulation and function. Thus, the present study intends to complement our previous findings by verifying the effects of this WT protocol on the autonomic, inflammatory, oxidative stress, and NO availability responses measured at rest and after a maximal exercise in patients with IC. Thirty patients will be randomly divided in 2 groups: WT (2 sessions/week, 15 sets of 2 min walking and 2 min of rest) e control (2 sessions/week, 30 min, stretching). At the beginning and after 12 weeks, the patients will undergo a maximal walking on a treadmill (Gardner's protocol) and before and after the exercise, we will measure: i) blood flow and vasodilatory response, ii) cardiovascular autonomic modulation, iii) muscle oxidative capacity; and iv) markers of inflammation, oxidative stress and NO availability on blood and muscle samples. (AU)

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Scientific publications (5)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
CHEHUEN, MARCEL DA ROCHA; CUCATO, GABRIEL GRIZZO; FERNANDES DE CARVALHO, CELSO RICARDO; ZERATI, ANTONIO EDUARDO; LEICHT, ANTHONY; WOLOSKER, NELSON; RITTI-DIAS, RAPHAEL MENDES; DE MORAES FORJAZ, CLAUDIA LUCIA. Treinamento de Caminhada Melhora a Variabilidade da Pressão Arterial Ambulatorial em Claudicantes. Arquivos Brasileiros de Cardiologia, v. 116, n. 5, p. 898-905, . (15/13800-0)
ANDRADE-LIMA, ALUISIO; SILVA JUNIOR, NATAN; CHEHUEN, MARCEL; MIYASATO, ROBERTO; SOUZA, RODRIGO W. A.; LEICHT, ANTHONY S.; BRUM, PATRICIA C.; DE OLIVEIRA, EDILAMAR M.; WOLOSKER, NELSON; FORJAZ, CLAUDIA L. M.. Walking Training Improves Systemic and Local Pathophysiological Processes in Intermittent Claudication. EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, v. 61, n. 6, p. 954-963, . (15/13800-0)
FECCHIO, RAFAEL YOKOYAMA; CHEHUEN, MARCEL; PECANHA, TIAGO; CUCATO, GABRIEL GRIZZO; RIANI COSTA, LUIZ AUGUSTO; LEICHT, ANTHONY SCOTT; RITTI-DIAS, RAPHAEL MENDES; WOLOSKER, NELSON; DE MORAES FORJAZ, CLAUDIA LUCIA. Reproducibility of heart rate recovery in patients with intermittent claudication. CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, v. 38, n. 4, p. 603-609, . (15/13800-0, 09/17371-6)
ANDRADE-LIMA, ALUISIO; JUNIOR, NATAN DA SILVA; CHEHUEN, MARCEL; MIYASATO, ROBERTO; SOUZA, RODRIGO W. A.; LEICHT, ANTHONY S.; BRUM, PATRICIA C.; DE OLIVEIRA, EDILAMAR M.; WOLOSKER, NELSON; FORJAZ, CLAUDIA L. M.. Local and Systemic Inflammation and Oxidative Stress After a Single Bout of Maximal Walking in Patients With Symptomatic Peripheral Artery Disease. JOURNAL OF CARDIOVASCULAR NURSING, v. 36, n. 5, p. 498-506, . (15/13800-0)
ANDRADE-LIMA, ALUISIO; CHEHUEN, MARCEL; SILVA JUNIOR, NATAN; FECCHIO, RAFAEL Y.; PECANHA, TIAGO; BRITO, LEANDRO C.; MIYASATO, ROBERTO; LEICHT, ANTHONY S.; FORJAZ, CLAUDIA L. M.. Reproducibility of Hemodynamic, Cardiac Autonomic Modulation, and Blood Flow Assessments in Patients with Intermittent Claudication. ANNALS OF VASCULAR SURGERY, v. 57, p. 144-151, . (15/13800-0)

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