Intensive Rehabilitation in Peripheral Arterial Disease With Claudication: Effects of a Treadmill Training With Active Recovery
Condition: Peripheral Arterial Disease; Claudication
MeSH terms: Peripheral Arterial Disease; Peripheral Vascular Diseases; Intermittent Claudication
Study type: Interventional
Phase: Phase 3

Summary: 
      Rehabilitation is the first intention treatment of peripheral arterial disease (PAD) with
      claudication. Initially proposed in the sixty's, rehabilitation programs dedicated to
      patients with PAD have recently been proved effective and defined in many guidelines.
      Supervised walking training on treadmill is recommended. Usually patients walk up to a mild
      or moderate pain (evaluated at 3 or 4 on the claudication pain scale; maximum pain =5), then
      stop until pain completely subsides and walk again .

      The Artex study assesses the efficacy of a fractionated mode of training avoiding pain by
      alternating short sequences of intensive training and active recovery (without rest).
    

Detailed description: 
      Fractionated mode of training with active recovery has been proved effective in sport
      training as well as in Cardiac rehabilitation. We hypothesized it might be also interesting
      in the rehabilitation of patients with a peripheral arterial disease. The active recovery
      period might magnified the beneficial effect of a short intensive training.
    

Intervention name(s): experimental rehabilitation program; conventional rehabilitation program
Intervention type(s): Procedure; Procedure
Intervention description(s): Duration training = 40 min : 5 cycles of 6 min each Week 1 speed of the walking exercise fixed at 70% of the max walking test's speed done on the initial walking test speed of the walking recovery fixed at 40% Walking slope : 0% Increase of the speed = 0.1 km/h after each training without pain.
Week 2 Walking speed = average of the walking speeds done on week 1 Walking slope = 1% Recovery slope = 0% Increase of the slope = 0.5% after each training without pain.
Week 3 Walking speed = 70% of the maximal walking test's speed Recovery speed = 40 % of the maximal walking test's speed Slope = average of the slopes done on week 2 Increase of the speed = 0.1 km/h .
Week 4 Speeds = average of the walking speeds done on week 3 Walking slope = 1% Recovery slope = 0% Increase of the slope is 0.5% .; Duration of the training 40 minutes (time excluding rest and warm up)
Initial intensity = 3.2 km per hour and slope at 0% Walking until pain 3/5, then stop until pain completely subsides.Resume of walking as soon as possible.
Increase :
Week 1: if the walking is possible during 8 minutes, increase of the slope of 0.5% in each training until 10% Week 2 :if the walking is possible during 8 minutes, increase of the speed 0.2 mile per hour until 3 mph Week 3 :if the walking is possible during 8 minutes, increase of the slope 2% at each training until 15% Week 4 : if the walking is possible during 8 minutes, increase the speed 0.2mph at each training as long as it is possible.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Assessment; Rehabilitation; Walking Constant Test; Walking Graded test; Six minute Walking test; Walking Distance