The Effect of High-intensity Interval Training on Initial Claudication and Absolute Walking Distance in Peripheral Artery Disease Patient: A Case Report

Abstract

Introduction: Peripheral arterial disease (PAD) causes significant functional impairment due to the presence of intermittent claudication (IC) during activities that caused activity restrictions. Aerobic exercise has been shown to improve walking ability and exercise performance. Case Description: A 55-year-old man undergoing phase II cardiac rehabilitation (CR) complained about moderate IC during activity and exercise that began from 2 weeks of exercise and increased until the end of phase II CR. Extended CR was given to increase initial claudication and absolute walking distances and physical activity level by giving a hybrid-CR program for 2 weeks. A supervised high-intensity interval training (HIIT) 2 times a week along with resistance exercise and home-based moderate-intensity aerobic exercise 3 times a week were given. After 2 weeks, there was an increase in initial claudication and absolute claudication distance of 23 meters and 91 meters from baseline, consecutively. Discussion: Aerobic exercise in PAD patients increases walking distance due to improvement in collateral flow, nitric oxide-dependent vasodilatation, inflammatory mediators, endothelial damage, oxygen delivery to working muscles, muscle contraction efficiency, and pain tolerance. Conclusion: Hybrid-CR with combination of a HIIT and moderate-intensity continuous aerobic exercise improved initial claudication and absolute walking distance in PAD patient.