Key result
Arm-ergometry and treadmill training improve exercise capacity by up to ~1.9 mL/kg/min versus control.
Why the study?
Supervised exercise is first-line treatment for peripheral artery disease, but the comparative benefits of treadmill training, arm-ergometry, and leg-ergometry remain unclear.
Do different supervised exercise modalities (treadmill, arm-ergometry, leg-ergometry) improve peak oxygen uptake and walking distance in adults with peripheral artery disease?
Meta-Analysis (n=519)
Do different supervised exercise modalities (treadmill, arm-ergometry, leg-ergometry) improve peak oxygen uptake and walking distance in adults with peripheral artery disease?
Supervised treadmill training and arm-ergometry both improve cardiorespiratory fitness in PAD patients, with treadmill training additionally providing significant improvements in maximal walking distance.
Answers are grounded in this paper and cite their sources.
Both modalities improve fitness in PAD; reinforces supervised exercise as first-line and extends options to arm-ergometry.
Objective: Supervised exercise is currently recognized as the first-line treatment for patients with peripheral artery disease. However, the comparative benefits of treadmill training, arm-ergometry, and leg-ergometry remain unclear. Review Methods: Medline, Embase, and the Cochrane Library were searched from inception to May 7, 2025, for randomized controlled trials in adults with peripheral artery disease. Eligible studies involved supervised treadmill, arm-ergometry, or leg-ergometry interventions lasting 12 to 24 weeks and compared these interventions with other exercise modalities or nonexercise controls. A frequentist random-effects network meta-analysis was conducted to estimate mean differences (MDs) with 95% CI for peak oxygen uptake, maximal walking distance, and pain-free walking distance. Summary: Eleven trials involving 519 participants were included. Arm-ergometry increased peak oxygen uptake by 1.85 mL/kg/min (95% CI, 0.99-2.71 mL/kg/min, P < .01), and treadmill training increased peak oxygen uptake by 1.46 mL/kg/min (95% CI, 1.12-1.81 mL/kg/min, P < .01) compared with control. Treadmill training increased maximal walking distance (MD = 191.25: 95% CI, 66.84-315.65 m, P < .01), whereas arm-ergometry showed no significant difference (MD = 121.35: 95% CI, −45.61 to 288.32 m, P = .15). In addition, pain-free walking distance improved with treadmill training (MD = 181.88: 95% CI, 154.99-208.76 m, P < .01), arm-ergometry (MD = 78.11: 95% CI, 54.62-101.60 m, P < .01), and leg-ergometry (MD = 51.08: 95% CI, 8.27-93.89 m, P = .02) compared with control.
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Ho et al. (2026) conducted a meta-analysis in Peripheral artery disease (n=519). Supervised exercise modalities (treadmill training, arm-ergometry, leg-ergometry) vs. Other exercise modalities or nonexercise controls was evaluated on Peak oxygen uptake (MD 1.85, 95% CI 0.99-2.71, p=<.01). Arm-ergometry and treadmill training increased exercise capacity compared with control.
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