PM&R
Volume 1, Issue 10 , Pages 932-940, October 2009

Effects of Exercise Training on Calf Tissue Oxygenation in Men With Intermittent Claudication

Parts of this paper were presented at the Annual Assembly of the American Academy of Physical Medicine and Rehabilitation in Boston (September 29, 2007) and San Diego (November 22, 2008) and at the Annual Meeting of the American College of Sports Medicine in Indianapolis (May 28, 2008).

  • Stephen F. Figoni, PhD, RKT

      Affiliations

    • Physical Medicine and Rehabilitation Service, VA Greater Los Angeles Healthcare System, VA West Los Angeles Healthcare Center, 11301 Wilshire Blvd., Los Angeles, CA†
    • Corresponding Author InformationAddress correspondence to: S.F.F.
    • ,
  • Charles F. Kunkel, MD

      Affiliations

    • Physical Medicine and Rehabilitation Service, VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA‡
    • ,
  • A.M. Erika Scremin, MD

      Affiliations

    • Physical Medicine and Rehabilitation Service, VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA§
    • ,
  • Arash Asher, MD

      Affiliations

    • UCLA/VA Greater Los Angeles Physical Medicine and Rehabilitation Residency Program, Los Angeles, CA∥
    • ,
  • Norman L. Banks, MD

      Affiliations

    • UCLA/VA Greater Los Angeles Physical Medicine and Rehabilitation Residency Program, Los Angeles, CA#
    • ,
  • Anthony Rivera, MD

      Affiliations

    • UCLA/VA Greater Los Angeles Physical Medicine and Rehabilitation Residency Program, Los Angeles, CA⁎⁎
    • ,
  • John K. Tin, MD

      Affiliations

    • UCLA/VA Greater Los Angeles Physical Medicine and Rehabilitation Residency Program, Los Angeles, CA††
    • ,
  • Babak Cohen, BS

      Affiliations

    • Physical Medicine and Rehabilitation Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA

Received 23 April 2009; accepted 30 August 2009.

Objective

To determine the effects of exercise training on calf tissue oxygenation in men with peripheral arterial disease and intermittent calf claudication.

Design

This pilot study was prospective and longitudinal and used a one-group, pretest-posttest design.

Setting

Tertiary care medical center for veterans.

Participants

Fifteen male veterans (mean age 69 years) with Fontaine stage IIa peripheral arterial disease and classic intermittent claudication.

Main Outcome Measurements

Before and after intervention, participants performed graded treadmill exercise tests while medial calf tissue oxygenation (StO2, % oxyhemoglobin saturation) was monitored continuously with near-infrared spectroscopy.

Intervention

The intervention consisted of a 3-month exercise training program involving 3 sessions per week at the clinic (treadmill walking, calf ergometry) and 2 sessions per week at home (free walking, standing heel raises).

Results

After completion of the intervention, participants significantly increased their maximal treadmill exercise time from 7.19 to 11.27 minutes. Mean exercise StO2 decreased from 29% to 19% saturation, StO2 × time area increased from 421%·min to 730%·min StO2 nadir, and StO2 recovery time did not change significantly.

Conclusions

After the exercise intervention, the improved treadmill walking performance was accompanied by greater calf tissue deoxygenation during exercise. Given the continued presence of ischemia, this finding may represent increased capillarization and diffusion-based enhancement of arteriovenous O2 extraction.

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  • † Disclosure: 8, Grant #B3644P from the Rehabilitation Research and Development Service, Department of Veterans Affairs
  • ‡ Disclosure: nothing to disclose
  • § Disclosure: 8, Grant #B3644P from the Rehabilitation Research and Development Service, Department of Veterans Affairs
  •  Disclosure: nothing to disclose
  • ∥ Disclosure: nothing to disclose
  • # Disclosure: nothing to disclose
  • ⁎⁎ Disclosure: nothing to disclose
  • †† Disclosure: nothing to disclose

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

PII: S1934-1482(09)01290-8

doi:10.1016/j.pmrj.2009.08.453

PM&R
Volume 1, Issue 10 , Pages 932-940, October 2009

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