The American Heart Association, Dallas, Texas

PAD is a progressive atherosclerotic disease in which plaque builds up and narrows the arteries in the extremities (usually the legs), limiting blood supply to the muscles during exertion. Starved for oxygen, these (usually calf) muscles can cramp and hurt after patients walk even short distances. The leg pain goes away with a few minutes of rest. PAD affects more than 8 million Americans, including about 20 percent of people older than 65 years.

Earlier studies have shown that progressive exercise training on a treadmill can help postpone the onset of leg pain or cramps, known medically as claudication, and can extend the distance patients can walk. In this study, researchers used an arm ergometer, a table-top device akin to bicycle pedals operated with the arms, rather than the legs.

The team measured how far 35 PAD patients (average age 67) could walk on a treadmill without leg pain, and how far they could continue to walk before pain forced them to stop. Then they randomly divided the patients into a control group that didn't exercise and three exercise groups. One group exercised on the treadmill, one on the arm ergometer, and the third group used both. M

The three groups exercised three times a week for 12 weeks in one-hour supervised sessions. After three months of training, patients in all three exercise groups improved in the total distance they could walk, ranging from 150 to 330 meters (equivalent to two to three and a half blocks). Both treadmill and arm exercisers showed similar improvement in the distance they could walk without pain: more than 100 meters, or about one and a half blocks.

"We were happy to discover that upper-body aerobics can help patients with PAD increase the distance they can walk without pain," Treat-Jacobson said. "We need additional studies to confirm the results, better understand why and how this works, and also identify the best training regimen for patients. In the meantime, our results provide evidence that aerobic upper-body exercise is a pain-free alternative for patients with PAD who cannot or do not wish to perform treadmill exercises because of leg pain or some other disability."

Click here for more information on research funded by the American Heart Association.

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