High-Intensity Progressive Resistance Training Improves Flat-Ground Walking in Older Adults with Symptomatic Peripheral Arterial Disease

Objectives To assess the efficacy of whole-body progressive resistance training (PRT) as a treatment for the symptoms of peripheral arterial disease (PAD) in older adults. Design Randomized controlled pilot trial. Setting University clinical weight training facility in Sydney, Australia. Participants Twenty-two older adults with symptomatic PAD. Interventions The efficacy of supervised whole-body high-intensity PRT (H-PRT) with low-intensity nonprogressive resistance training (L-RT) and a usual care control group that performed unsupervised walking for 6 months was compared. Measurements Pilot outcome measures included 6-minute walk (6 MW) outcomes, body composition, dynamic muscle strength and endurance, and performance-based tests of function. Results Mean age was 71.1 ± 7.2. Mean ankle brachial index was 0.55 ± 0.13. Exercise adherence was similar in all groups (P = .29). H-PRT (n = 8) improved total 6MW distance (mean difference (MD) 62.6 ± 58.0 m, P = .02) significantly more than L-RT (n = 7; MD=−48.2 ± 67.6 m) and controls (n = 7; MD=−9.9 ± 52.9 m). Change in 6MW onset of claudication was significantly and independently related to change in bilateral calf endurance (correlation coefficient (r) = 0.65, P = .03), and change in 6MW distance was significantly and independently related to change in bilateral hip extensor endurance (r = 0.71, P = .02) in all groups. Conclusion H-PRT significantly improved 6MW ability in older adults with intermittent claudication from PAD, whereas L-RT and unsupervised walking did not. Improvement in walking ability was significantly related to improvements in bilateral calf and hip extensor endurance, supporting further investigations targeted at musculoskeletal impairment in this cohort.