Walking training as a means to improve the vasodilatory function of endothelium in patients with intermittent claudication

Aim of the study: In patients with intermittent claudication, regular treadmill walking training improves the walking distance. The mechanism of this improvement is a multi-factorial one, and one of the probable reasons may be the improved function of the vascular endothelium. The purpose of the paper is to evaluate the vasodilatory function of endothelium and changes of walking capability in patients with intermittent claudication participating in a 12-week controlled treadmill walking training.

Material and methods: The study included 25 subjects aged 64 ±8 years with lower-extremity atherosclerosis evaluated according to the Fontaine’s classification as degrees IIA and IIB.

Before and after finishing the training, walking capability evaluation was performed on the basis of a walking test according to Gardner protocol and vascular endothelial function was assessed using the method of determining the degree of dilatation of the brachial artery – FMD (flow-mediated dilatation).

Results: After completion of the training, time to claudication was extended by 96% and maximum walking time by 109%. The improvement in FMD was 59%.

Conclusions: A 12-week controlled treadmill walking training leads to improvement of walking capability in patients with intermittent claudication.

Flow-mediated dilatation increase observed after 12 weeks of training points to the improved function of vascular endothelium. Improvement of the vascular endothelial vasodilatory function may be one of the important mechanisms of improving walking capability in patients with intermittent claudication.