Skip to main content
Top
Published in: European Journal of Applied Physiology 2/2009

01-05-2009 | Original Article

Plantar flexion training primes peripheral arterial disease patients for improvements in cardiac function

Authors: Jan Helgerud, Eivind Wang, Mats Peder Mosti, Øystein Nordrum Wiggen, Jan Hoff

Published in: European Journal of Applied Physiology | Issue 2/2009

Login to get access

Abstract

This study investigated if initial calf muscle training immediately followed by whole body training improved aerobic power and cardiovascular function in peripheral arterial disease (PAD) patients. The training group (n = 10) pursued 8 weeks of high aerobic intensity plantar flexion interval training continued by 8 weeks of high aerobic intensity treadmill training. The control group (n = 11) received advice according to exercise guidelines. Treadmill VO2peak and time to exhaustion increased significantly with 16.8 and 23.4% during the plantar flexion training period while no changes occurred in heart stroke volume (SV). Following treadmill training, SV increased with 25.1% while treadmill VO2peak and time to exhaustion increased 9.9 and 16.1%. Plantar flexion training was effective for increasing treadmill VO2peak and time to exhaustion in PAD patients and amplified the effects of the additional treadmill training, as SV increased and treadmill VO2peak and time to exhaustion improved further. This study suggests that calf muscle training prime PAD patients for cardiovascular adaptations when applying whole body exercise.
Literature
go back to reference Åstrand PO, Rodahl K, Dahl HA, Strømme SB (2003) Textbook of work physiology. Physiological bases of exercise. Human Kinetics, Leeds Åstrand PO, Rodahl K, Dahl HA, Strømme SB (2003) Textbook of work physiology. Physiological bases of exercise. Human Kinetics, Leeds
go back to reference Booth FW, Chakravarthy MV, Gordon SE, Spangenburg EE (2002) Waging war on physical inactivity: using modern molecular ammunition against an ancient enemy. J Appl Physiol 93:3–30PubMed Booth FW, Chakravarthy MV, Gordon SE, Spangenburg EE (2002) Waging war on physical inactivity: using modern molecular ammunition against an ancient enemy. J Appl Physiol 93:3–30PubMed
go back to reference Gardner AW, Katzel LI, Sorkin JD, Bradham DD, Hochberg MC, Flinn WR, Goldberg AP (2001) Exercise rehabilitation improves functional outcomes and peripheral circulation in patients with intermittent claudication: a randomized controlled trial. J Am Geriatr Soc 49:755–762. doi:10.1046/j.1532-5415.2001.49152.x PubMedCrossRef Gardner AW, Katzel LI, Sorkin JD, Bradham DD, Hochberg MC, Flinn WR, Goldberg AP (2001) Exercise rehabilitation improves functional outcomes and peripheral circulation in patients with intermittent claudication: a randomized controlled trial. J Am Geriatr Soc 49:755–762. doi:10.​1046/​j.​1532-5415.​2001.​49152.​x PubMedCrossRef
go back to reference Haseler LJ, Lin A, Hoff J, Richardson RS (2007) Oxygen availability and PCr recovery rate in untrained human calf muscle: evidence of metabolic limitation in normoxia. Am J Physiol 293:R2046–R2051 Haseler LJ, Lin A, Hoff J, Richardson RS (2007) Oxygen availability and PCr recovery rate in untrained human calf muscle: evidence of metabolic limitation in normoxia. Am J Physiol 293:R2046–R2051
go back to reference Helgerud J (1994) Maximal oxygen uptake, anaerobic threshold and running economy in women and men with similar performances level in marathons. Eur J Appl Physiol Occup Physiol 68:155–161. doi:10.1007/BF00244029 PubMedCrossRef Helgerud J (1994) Maximal oxygen uptake, anaerobic threshold and running economy in women and men with similar performances level in marathons. Eur J Appl Physiol Occup Physiol 68:155–161. doi:10.​1007/​BF00244029 PubMedCrossRef
go back to reference Helgerud J, Hoydal K, Wang E, Karlsen T, Berg P, Bjerkaas M, Simonsen T, Helgesen C, Hjorth N, Bach R, Hoff J (2007) Aerobic high-intensity intervals improve VO2 max more than moderate training. Med Sci Sports Exerc 39:665–671. doi:10.1249/mss.0b013e3180304570 PubMedCrossRef Helgerud J, Hoydal K, Wang E, Karlsen T, Berg P, Bjerkaas M, Simonsen T, Helgesen C, Hjorth N, Bach R, Hoff J (2007) Aerobic high-intensity intervals improve VO2 max more than moderate training. Med Sci Sports Exerc 39:665–671. doi:10.​1249/​mss.​0b013e3180304570​ PubMedCrossRef
go back to reference Hiatt WR, Regensteiner JG, Hargarten ME, Wolfel EE, Brass EP (1990) Benefit of exercise conditioning for patients with peripheral arterial disease. Circulation 81:602–609PubMed Hiatt WR, Regensteiner JG, Hargarten ME, Wolfel EE, Brass EP (1990) Benefit of exercise conditioning for patients with peripheral arterial disease. Circulation 81:602–609PubMed
go back to reference Hiatt WR, Wolfel EE, Meier RH, Regensteiner JG (1994) Superiority of treadmill walking exercise versus strength training for patients with peripheral arterial disease. Implications for the mechanism of the training response. Circulation 90:1866–1874PubMed Hiatt WR, Wolfel EE, Meier RH, Regensteiner JG (1994) Superiority of treadmill walking exercise versus strength training for patients with peripheral arterial disease. Implications for the mechanism of the training response. Circulation 90:1866–1874PubMed
go back to reference Hiatt WR, Regensteiner JG, Wolfel EE, Carry MR, Brass EP (1996) Effect of exercise training on skeletal muscle histology and metabolism in peripheral arterial disease. J Appl Physiol 81:780–788PubMed Hiatt WR, Regensteiner JG, Wolfel EE, Carry MR, Brass EP (1996) Effect of exercise training on skeletal muscle histology and metabolism in peripheral arterial disease. J Appl Physiol 81:780–788PubMed
go back to reference Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM Jr, White CJ, White J, White RA, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B (2006) ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation 113:e463–e654. doi:10.1161/CIRCULATIONAHA.106.174526 PubMedCrossRef Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM Jr, White CJ, White J, White RA, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B (2006) ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation 113:e463–e654. doi:10.​1161/​CIRCULATIONAHA.​106.​174526 PubMedCrossRef
go back to reference Klausen K, Secher NH, Clausen JP, Hartling O, Trap-Jensen J (1982) Central and regional circulatory adaptations to one-leg training. J Appl Physiol 52:976–983PubMed Klausen K, Secher NH, Clausen JP, Hartling O, Trap-Jensen J (1982) Central and regional circulatory adaptations to one-leg training. J Appl Physiol 52:976–983PubMed
go back to reference Richardson RS, Grassi B, Gavin TP, Haseler LJ, Tagore K, Roca J, Wagner PD (1999) Evidence of O2 supply-dependent VO2 max in the exercise-trained human quadriceps. J Appl Physiol 86:1048–1053PubMed Richardson RS, Grassi B, Gavin TP, Haseler LJ, Tagore K, Roca J, Wagner PD (1999) Evidence of O2 supply-dependent VO2 max in the exercise-trained human quadriceps. J Appl Physiol 86:1048–1053PubMed
go back to reference Tjonna AE, Lee SJ, Rognmo O, Stolen TO, Bye A, Haram PM, Loennechen JP, Al-Share QY, Skogvoll E, Slordahl SA, Kemi OJ, Najjar SM, Wisloff U (2008) Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study. Circulation 118:346–354. doi:10.1161/CIRCULATIONAHA.108.772822 PubMedCrossRef Tjonna AE, Lee SJ, Rognmo O, Stolen TO, Bye A, Haram PM, Loennechen JP, Al-Share QY, Skogvoll E, Slordahl SA, Kemi OJ, Najjar SM, Wisloff U (2008) Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study. Circulation 118:346–354. doi:10.​1161/​CIRCULATIONAHA.​108.​772822 PubMedCrossRef
go back to reference Wagner PD (2000) New ideas on limitations to VO2max. Exerc Sport Sci Rev 28:10–14PubMed Wagner PD (2000) New ideas on limitations to VO2max. Exerc Sport Sci Rev 28:10–14PubMed
go back to reference Weitz JI, Byrne J, Clagett GP, Farkouh ME, Porter JM, Sackett DL, Strandness DE Jr, Taylor LM (1996) Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical review. Circulation 94:3026–3049PubMed Weitz JI, Byrne J, Clagett GP, Farkouh ME, Porter JM, Sackett DL, Strandness DE Jr, Taylor LM (1996) Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical review. Circulation 94:3026–3049PubMed
go back to reference Wisloff U, Stoylen A, Loennechen JP, Bruvold M, Rognmo O, Haram PM, Tjonna AE, Helgerud J, Slordahl SA, Lee SJ, Videm V, Bye A, Smith GL, Najjar SM, Ellingsen O, Skjaerpe T (2007) Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation 115:3086–3094. doi:10.1161/CIRCULATIONAHA.106.675041 PubMedCrossRef Wisloff U, Stoylen A, Loennechen JP, Bruvold M, Rognmo O, Haram PM, Tjonna AE, Helgerud J, Slordahl SA, Lee SJ, Videm V, Bye A, Smith GL, Najjar SM, Ellingsen O, Skjaerpe T (2007) Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation 115:3086–3094. doi:10.​1161/​CIRCULATIONAHA.​106.​675041 PubMedCrossRef
Metadata
Title
Plantar flexion training primes peripheral arterial disease patients for improvements in cardiac function
Authors
Jan Helgerud
Eivind Wang
Mats Peder Mosti
Øystein Nordrum Wiggen
Jan Hoff
Publication date
01-05-2009
Publisher
Springer-Verlag
Published in
European Journal of Applied Physiology / Issue 2/2009
Print ISSN: 1439-6319
Electronic ISSN: 1439-6327
DOI
https://doi.org/10.1007/s00421-009-1011-z

Other articles of this Issue 2/2009

European Journal of Applied Physiology 2/2009 Go to the issue