Acute Responses to Arm-Crank Exercise on the Cardiovascular Function of Patients With Peripheral Artery Disease: A RANDOMIZED CROSSOVER TRIAL

Purpose: To analyze the acute cardiovascular responses to arm-cranking (AC) exercise in patients with peripheral artery disease (PAD), comparing it to walking and a nonexercise control condition. Methods: This study is a randomized crossover trial with single-blind data collection in which 17 patients with PAD and claudication (53% men, 66 ± 7 years old, 26.7 ± 4.4 kg/m 2 body mass index, 0.63 ± 0.12 ankle-brachial index) were included. They performed 3 experimental conditions (walking, AC, and control) in random order. The exercise conditions were composed of 15 bouts of 2 minutes (15 × 2) with an intensity equivalent to 4 to 6 on a modified (1–10) Borg Rating of Perceived Exertion scale. We measured blood pressure (BP), cerebral blood flow, heart rate variability, and brachial and femoral artery flow-mediated dilation before and after the conditions. Generalized estimated equations were used to analyze the acute response among experimental conditions, with P < .05 considered significant. Results: We observed post-exercise hypotension in both AC and walking, with a greater net effect in the AC condition compared with walking (systolic BP: AC = −14 ± 14 mm Hg; walking = −6.7 ± 8.9 mm Hg, P < .001; diastolic BP: AC = −5.8 ± 8.4 mm Hg; walking = −1.2 ± 4.1 mm Hg, P = .011). Brachial and femoral artery flow-mediated dilation, cerebral blood flow, and heart rate variability did not change after any of the conditions. Conclusion: Vascular function, cerebral blood flow, and heart rate variability remained unchanged after AC and walking. However, both walking and AC induced post-exercise hypotension in patients with PAD, with a greater magnitude in the AC condition.