Structured Resistance Exercise and Remote Ischemic Preconditioning for Moderate Intermittent Claudication

Structured Resistance Exercise and Remote Ischemic Preconditioning for Moderate Intermittent Claudication Background: Walking is the recommended mode of exercise and has been proven effecting for management of moderate intermittent claudication (IC). There is currently limited information on the effect of remote ischemic preconditioning (RIPC) and structured exercise (SE), specifically full body exercise using resistance bands, for improving walking ability. Aim: To determine if an at home structured resistance exercise programme would elicit similar improvements in walking ability, quality of life (QOL), body strength endurance and blood pressure in individuals with moderate IC when compared to a combination intervention of RIPC and at home structured resistance exercise. Methodology: Thirty-one participants were randomized (25 males and 6 females; age 66 years; 29% current smokers, 71% ex-smokers, 25.8% with diabetes mellitus) with moderate IC. Fifteen participants were randomized into the RIPC and 12-week SE (RIPCS+SE) and sixteen were randomized into the 12-week at home structured resistance exercise programme. Walking abilities (6 minute walk test; pain free walking distance [PFWD], total walking distance [TWD]) and body strength endurance were assessed at baseline, at 6-weeks and after 12 weeks. Blood pressure and QOL (EQ-5D-3L) were assessed at baseline and 6-weeks into the study. Data was compared within and between groups (p=0.05). Key Findings: After six-weeks a significant improvement was seen in both the SE (.016) and the RIPC+SE group (.012). At twelve-weeks the RIPC+SE had significant improvement in PFWD (.028). The SE group had greater improvements in their TWD when compared to the RIPC+SE group. Both groups shown positive improvements in body strength endurance, QOL and the RIPC+SE group elicited greater improvements in blood pressure. Conclusion: After six and twelve weeks the implementation of both SE and RIPC+SE proved to elicit similar positive improvements in walking abilities for patients with moderate IC. Clinicians should consider recommending an at home full body resistance SE over RIPC.