Polestriding Versus Walking for Subjects With Poor Leg Circulation

Study Overview
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Brief Summary
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The purpose of this study is to compare the effects of polestriding (walking with poles) and traditional walking on physical endurance in subjects with poor circulation in their legs. Another goal is to evaluate the effectiveness of a walking program in increasing the amount of oxygen in the calf muscles and therefore improving overall physical activity and quality of life.

Detailed Description
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Peripheral Arterial Disease (PAD/PVD) is caused by decreased blood flow to the legs. The most common symptom is intermittent claudication pain during walking that is relieved by rest. Walking is the primary treatment prescribed for PAD rehabilitation. Polestriding uses muscles of the upper and lower body in a continuous movement. Walking with poles increases stride length, cadence and walking speed and decreases ground reaction forces on the joints. Subjects in this study will participate in a walking program with or without poles. Dr. Collins' research focuses on physical activity interventions to improve the functional status of persons with chronic illness. Several rehabilitation studies have tested the efficacy of walking exercise for patients with PAD. Studies on polestriding indicate that it may be superior to traditional walking, but these two methods have never been compared. Approximately 30% of patients with coronary artery disease have PAD as their only symptom. As the population ages and more people are affected by this debilitating condition, nurse-initiated rehabilitative therapies, such as polestriding, need to be explored. The consent form explains the purpose of the study in addition to the procedures, risks, benefits, options, confidentiality, costs, and compensation. Participants are also asked to sign a HIPPA authorization.

Official Title
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Polestriding Versus Walking for PAD Rehabilitation

Conditions
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Peripheral Arterial Disease

Intervention / Treatment
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* Behavioral: Walking with poles
* Behavioral: Walking exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Peripheral Vascular Disease Cramping/Claudication Pain in legs while walking Ankle Brachial Index (measure of circulation by doppler) .90 or less Exclusion Criteria: Ulcers or sores on feet or legs Unable to walk or confined to a wheelchair Amputations or severe arthritis pain in shoulders, knees, or hips Medical conditions which would exclude subject from participating in an exercise program Vascular Surgery within the last six months, or planning vascular surgery

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Walking with Poles<br>Patients were assigned to a 24 week walking with poles program of rehabilitation. The intervention was the additional of poles to the walking program. | Behavioral: Walking with poles<br>* Patients walked with poles, 20-45 minutes, 3 times/week for 24 weeks.<br>* Other names: Exercise;|
| Active Comparator: Traditional walking program<br>Patients were assigned to a 24 week traditional walking program. | Behavioral: Walking exercise<br>* Patients walked for 20-45 minutes, 3 times/week for 24 weeks.<br>* Other names: Exercise;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of Exercise Duration on the Treadmill Constant Work Rate Exercise Test | Patients walked on the CWR test at 85% of his/her peak VO2 on the baseline progressive treadmill test. Since the polewalking group was older than the walking group, subject age was entered into the analysis as a co-variate. Intent-to-treat (ITT) analyses were used. The last measurement taken for all subjects with at least one follow-up test was carried forward (n=97). | Baseline and 24 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Onset of Claudication Pain During Constant Work Rate Treadmill Test | Perceived pain onset was recorded during the constant workrate test using the Borg ratio scale. Patient rated their pain from 0-10. Time elapased on the treadmill (minutes) at the onset of pain was recorded. | At 24 weeks |