Research by UNSW medical researchers recently published in the British Journal of Sports Medicine has shown that peripheral artery disease patients can reduce painful symptoms such as muscle cramps during walking with the help of weight training.
People suffering from peripheral artery disease (PAD), develops a plaque in the arteries due to high cholesterol levels, nicotine, and other cardiovascular risk factors. The plaque formation leads to the narrowing of the arteries and ultimately reduced blood supply to the legs.
With the progression of PAD, patients get muscle cramps while walking or jogging due to the decreased supply of oxygen to the legs, rest can help in relieving the pain. The cramping pain leads to patients restrain from walking and other cardio-workouts that may cause the pain, this gradually promotes vascular diseases due to inactivity, which may lead to myocardial infarction or stroke.
A lead author Dr. Belinda Parmenter, Certified Exercise Physiologist and Deputy Head of UNSW’s School of Medical Sciences says; “One of the biggest issues is that peripheral artery disease is asymptomatic to start and only gets diagnosed when patients present to their doctor with the cramping pain. This means it has already progressed.”
“Once symptoms kick in, they can often be painful—we call the main symptom intermittent claudication. Essentially, it means people experience severe muscle cramps when they are physically active, like when walking, which is then relieved by rest.”
Exercise is the first-line treatment prescribed for PAD patients. Physicians advise them to take intervals while walking to improve symptoms.
Dr. Parmenter says; “Doctors’ main recommendation for people with PAD is to walk, as it is the most effective treatment for symptoms of the disease. However, this prescription often means that a lot of patients can’t and don’t comply, due to the pain the walking causes them.”
Dr. Parmenter worked on additional treatment options for PAD patients, as the patients may be suffering from the side effects of a stroke, amputations, or pain that can be so severe that they abstain from walking.
“I got the idea to study resistance training from my dad—he’s a vascular surgeon who said to me “What do I do about my patients who can’t walk? How can I help them?”
Dr. Parmenter took it as a challenge and started exploring the potential benefits of resistance training for victims of PAD. She came up with the idea that high-intensity intermittent exercise effectively improves walking ability in PAD patients.
“It’s really exciting—we found that high-intensity weight training improves people’s walking ability. The results indicated that it was effective at improving all forms of walking—both graded treadmill and flat ground walking. It improved how far someone could walk before the pain kicked in, and their total walking distance,” she says.
“Crucially, weight training allows patients to train the muscle groups that aren’t affected by claudication, so they can avoid cramps altogether during the sessions.”
Added into it, Dr. Parmenter’s research shows that PAD can also mask heart disease. PAD patients prefer inactivity due to the cramping pain in legs due to lack of oxygen and blood supply, thus avoiding any forms of aerobic exercise. Ultimately leads to evoking the symptoms of heart disease.
“The leg pain often stops them during any cardiac stress testing protocols too, so we don’t ever get to see how the heart is coping under higher loads,” Dr. Parmenter says.
“This is another reason why weight training is so powerful for patients with PAD—it helps to improve their ability to walk and complete other forms of exercise. Once they can work a bit harder, we often end up diagnosing heart disease, and can intervene before it’s too late.”
Dr. Parmenter helped one of her patients in building muscle strength and tolerance, thus improved her patient’s walking abilities through sprint interval training. Once the patient’s body adapted to work harder, she then started experiencing unusual shortness of breath and chest tightness at the higher intensity workouts. These symptoms led to the diagnosis of ischemic heart disease. Quadruple bypass enabled the patient to recover well and is now fitter than ever.
Dr. Parmenter says “If we didn’t improve her walking capacity, we would have never known about the heart disease.”
Now, the researchers hope that their findings will be fruitful in treating PAD.
“The evidence is now there for doctors to refer their patients to the gym for a lower bodyweight training program in order for them to improve their claudication and mobility,” Dr. Parmenter says.
“Our previous research led to resistance training being included in American and Australian guidelines for the treatment of PAD, in addition to walking—now that we have this much stronger evidence, we hope that it will be included as an option that can be used instead of walking, as well,” Dr. Parmenter says.
Conclusively, the trials show that weight training is the best way of strength training for developing the strength and size of skeletal muscles.
It improves each of the biological risk factors for cardiovascular disease, including overweight and obesity. But also, weight training improves insulin sensitivity thus controlling blood glucose levels, and reduced blood pressure as well as a reduction in blood pressure. Therefore, weight training has benefits for all. Physicians recommend both healthy individuals and those with CVS diseases to do a moderate to high-intensity workout.