COMPARISON OF TREADMILL WALKING AND STAIR CLIMBING OVER A RANGE OF EXERCISE INTENSITIES IN PERIPHERAL VASCULAR OCCLUSIVE DISEASE

Although claudication pain and hemodynamic responses to exercise are r elated to the degree of arterial narrowing in the lower extremities, t he nature of these responses to different exercise tasks and intensiti es is less clear. Thus, the purpose of this study was to compare claud ication and hemodynamic responses to graded walking, level walking, an d stair climbing over a range of exercise intensities. Ten patients wi th peripheral vascular occlusive disease performed five tests within e ach of the three exercise tasks. Similar values of oxygen consumption were obtained among exercise tasks at each intensity (p = ns). Time to onset of claudication pain and to maximal pain were similar among exe rcise tasks (p = ns), and both demonstrated a curvilinear decrease as intensity increased (p < 0.05). Foot transcutaneous oxygen tension, an kle systolic blood pressure, and ankle/brachial systolic pressure inde x were also similar among the three exercise tasks (p = ns); however, each decreased linearly as exercise intensity increased (p < 0.05). Th us, in peripheral vascular occlusive disease, the imbalance between ox ygen delivery to the exercising lower extremity musculature and the lo cal metabolic demand is similar during different weight-bearing activi ties. Second, even though the peripheral circulation is progressively impaired with increased exercise intensity, anaerobic metabolism in th e ischemic lower extremity musculature may prevent a continual decline in claudication times. The clinical implication is that a more thorou gh assessment of the functional limitations imposed by claudication pa in is not obtained by using different types of weight-bearing exercise tests as opposed to using only one type.