Functional Impairment in Peripheral Artery Disease and How to Improve It in 2013

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• 作者：Mary McGrae McDermott (1)
  
• 关键词：Peripheral artery disease ; Intermittent claudication ; Physical functioning ; Exercise rehabilitation
• 刊名：Current Cardiology Reports
• 出版年：2013
• 出版时间：April 2013
• 年：2013
• 卷：15
• 期：4
• 全文大小：176KB
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  32. 鈥⑩€?McDermott MM, Ades P, Guralnik JM, Dyer A, Ferrucci L, Liu K, et al. Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial. JAMA. 2009;301:165鈥?4. / This randomized controlled clinical trial of exercise in participants with PAD is the first to include PAD participants both with and without symptoms of classical intermittent claudication. Most participants do not have classical symptoms of intermittent claudication. The manuscript also includes a resistance training intervention. CrossRef
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  43. Pipinos II, Sharov VG, Shepard AD, Anagnostopoulos PV, Katsamouris A, Todor, et al. Abnormal mitochondrial respiration in skeletal muscle in patients with peripheral arterial disease. J Vasc Surg. 2003;38:827鈥?2. CrossRef
  44. McDermott MM, Hoff F, Ferrucci L, Pearce WH, Guralnik JM, Tian L, et al. Lower extremity ischemia, calf skeletal muscle characteristics, and functional impairment in peripheral arterial disease. J Am Geriatr Soc. 2007;55:400鈥?. CrossRef
  45. McDermott MM, Carroll T, Kibbe M, et al. Proximal superficial femoral artery occlusion, collateral vessels, and walking performance in peripheral artery disease. J Am Coll Cardiol. Imaging (in press).
  
• 作者单位：Mary McGrae McDermott (1)
  
  1. Northwestern University, Feinberg School of Medicine, 750 N. Lake Shore Drive, Chicago, IL, 60611, USA
  

文摘

Lower extremity peripheral artery disease (PAD) affects 8 million men and women in the United States and will be increasingly common as the U.S. population lives longer with chronic disease. People with PAD have poorer walking endurance, slower walking velocity, and poorer balance, compared with individuals without PAD. People with PAD may reduce their walking activity to avoid leg symptoms. Thus, clinicians should not equate stabilization or improvement in exertional leg symptoms with stabilization or improvement in walking performance in PAD. In addition, even asymptomatic PAD patients have greater functional impairment and faster functional decline than individuals without PAD. Of the 2 FDA-approved medications for treating claudication symptoms, pentoxifylline may not be more efficacious than placebo, whereas cilostazol confers a modest improvement in treadmill walking performance. Supervised treadmill walking exercise is associated with substantial improvement in walking endurance, but many PAD patients do not have access to supervised exercise programs. Unsupervised walking exercise programs may be beneficial in PAD, but data are mixed.