Best Exercises for Peripheral Artery Disease
Peripheral artery disease (commonly referred to as PAD) is the narrowing or blockage of the vessels that carry blood to the legs and feet. It is primarily caused by the buildup of fatty plaque in the arteries, which is called atherosclerosis. PAD can happen in any blood vessel, but it is more common in the legs.
The decreased blood flow can lead to common symptoms such as pain in the lower legs/calf during walking, which is relieved with rest, called intermittent claudication. This can progress to pain in the legs at rest, as well as wounds that don’t heal in the lower legs and feet. If left untreated, peripheral artery disease may result in amputation. Having peripheral artery disease greatly increases the risk of heart attack, stroke and premature death. It is estimated that over 200 million people worldwide and 8.5 million Americans over the age of 40 have peripheral artery disease. Risk factors for peripheral artery disease include:
- High blood pressure
- High cholesterol
- Age above 40 years
Treatment of peripheral artery disease involves the use of medications, including antiplatelet agents such as aspirin, cholesterol-lowering medications called statins, and stopping smoking.
Managing PAD Pain with Structured Exercise Therapy
Several studies have shown that supervised exercise therapy is effective at reducing leg symptoms in patients with intermittent claudication from peripheral artery disease. This allows patients to walk longer distances without pain, which improves functional status and quality of life. The sessions consist of 30-60 minutes of graded exercise on a treadmill, which is supervised by a physician or other trained, qualified personnel, and are conducted in a hospital outpatient setting or a physician’s office. After a five-minute warm-up period, participants are asked to walk on the treadmill until they have mild to moderate pain.
They are then asked to stop, sit down and rest until the pain has completed resolved. Then they resume walking. The goal is to reach an exercise session of 50 minutes in duration (including rest periods), which allows for five-minute warm-up and cool-down periods to bring the total session duration to 60 minutes.
Home-Based Exercise for PAD
For people who do not have access to supervised exercise therapy, studies have shown that home-based programs can improve walking endurance and physical activity in patients with PAD. Patients should engage in walking exercise at least five days per week, working up to 50 minutes per exercise session. Patients are advised to walk to severe leg discomfort (a severity of 4 or 5 on a scale of 0-5) and rest until the discomfort subsides enough to resume walking.
Alternative Exercise Strategies for Patients With PAD
Whereas treadmill walking is the most recommended form of exercise therapy for patients with claudication, the following exercises are reasonable alternatives for improving leg symptoms in patients with PAD:
Leg Cycling Exercise Training
Ten repetitions of leg cycling, done for two minutes each with two minutes of rest in between.
Aerobic Arm Exercise Training
Twenty minutes of arm cranking or arm cycling for 20 minutes of exercise per session, two times per week, for 12 to 14 weeks. Arm cranks, also known as arm or upper-body ergometers, enable you to pedal with your arms on an exercise machine that resembles an inverted stationary cycle.
Three sets of eight repetitions of exercises for different upper and lower body muscle groups. Build up slowly to the maximum number of repetitions.
Don’t let your PAD symptoms keep you from the things you love to do. Talk with your doctor about these exercises and other treatments for PAD and get moving!
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