Diane Treat-Jacobson, Ph.D, R.N.
Awardee Name: Diane Treat-Jacobson, Ph.D., R.N.
Institution: University of Minnesota School of Nursing
Arm Workouts Reduce Leg Pain Caused by Peripheral Arterial Disease
Funded by a scientist development grant from the American Heart Association’s Greater Midwest Affiliate, researchers have discovered that aerobic arm exercises can delay the onset of leg pain that makes walking even short distances difficult for many people with peripheral arterial disease (PAD).
“This is the first study showing that arm-only aerobics can provide results comparable to those seen with treadmill training,” said Diane Treat-Jacobson, Ph.D., R.N., lead author of the study and an assistant professor at the University of Minnesota School of Nursing in Minneapolis.
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 over age 65. It is associated with significant disability and death, according to the AHA.
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 did not exercise and three exercise groups. One group exercised on the treadmill, one on the arm ergometer, and the third group used both.
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 showed improvement 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 with out 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.”
The results of the study were reported atthe American Heart Association’s Scientific Sessions 2006. Co-authors are Ulf G. Bronas, a doctoral candidate who has a Pre-doctoral Fellowship award from the AHA’s Greater Midwest Affiliate, and Arthur S. Leon, M.D., M.S.