Object

Title: Meaning of endurance tests for treadmill treaning program qualification in patients with claudication

Abstract:

According to current views, march training on treadmill becomes an essential part of treatment for patients with claudication. The latest TASC II recommendations have significantly changed the main rule of the training march on the treadmill. Nowadays, it is recommended that the patients should stop walking when their pain reaches a ”mean” intensity while previously they were told to stop treading the moment pain appeared. For a kinesitherapeutist, supervising trainings on treadmill, the main question remains how to recognise in practise “mean” intensity of pain. This is why, the primary aim of the study was to establish what range of march, in practise corresponds to “mean” intensity of pain as well as what were the hemodynamic consequences of marching (walking) with pain. Having reached mean results of treadmill march for 35 patients with advanced II grade morbidity according to Fontaine’s scale, it was found that painless distance accounts for 60 percent of maximal distance, while main intensity of pain lasts up to 85 % of maximal distance, with this distance being determined as submaximal. As of that moment the pain tends to increase. The presented data indicate that a patient on treadmill, suffering pain in the shanks, covers a distance which is equivalent to 25 percent of the maximal distance. The enhanced requirements concerning patients, as a rule suffering from multiple arteriosclerotic complaints, enforced more detailed examination of patients with claudication before submitting them to full training on treadmill, after a single test including blood pressure, heart rate and ECG measurements in subsequent phases of the march, i.e. at the beginning of shank pain, after submaximal distance and maximal distance. Spirometric tests had been carried ouf before marching test as well. Based on diagnostic marching test it was stated that 17 % (6/35) failed to qualify for a complete training on the treadmill i. e. 5 owing to increased diastolic pressure (up to 115 mm Hg) already at the phase of starting pain including one person because of simultaneous overstepping proper limit of submaximal heart rate and of ST segment decreases in ECG and one owing to overstepping of the heart rate limit. Moreover, no interdependence was observed between increased pressure on the upper limb and decreased pressure on the lower limb. Based on spirometric tests it was found that decreased respiratory capacity of the lungs exerts influence on shortening claudication distance. It was also found that claudication distance as evaluated subjectively by the patient differs significantly from the distance evaluated objectively in hospital by accompaning person during march along the corridor, that is even 80% of the patients estimated their walking distance to be shorter than the one measured objectively. Only exceptionally the patients were earlier informed how to take rationally their daily walks. Before undertaking march training on treadmill with claudication patients it is necessery to perform diagnostic test march including measurments of pressure, heart rate and ECG recording during and immediately after march in order to exclude patients unable to undertake full training effort. Result of corridor test with assisting physiotherapist might be helpful for vascular surgeon to undertake decisions concerning further treatment. Functional tests assessing sufficiency in patients with peripheral arterial occlusive disease is of great value, helping in qualification for further march training or revasularisation. They also provide unique opportunity for education of the patients, which by all means remains very important for treatment efficiency.

Level of degree:

2 - studia doktoranckie

Degree discipline:

choroby układu krążenia ; rehabilitacja

Degree grantor:

Wydział Nauk o Zdrowiu

Promoter:

Jolanta Jaworek

Date issued:

2010

Format:

application/msword

Identifier:

oai:dl.cm-uj.krakow.pl:828

Call number:

ZB-113636

ControlNumberVIRTUA:

click here to follow the link

Access rights:

nieograniczony

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

Object collections:

Last modified:

Oct 14, 2019

In our library since:

Nov 21, 2012

Number of object content hits:

616

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/828

Show description in RDF format:

RDF

Show description in OAI-PMH format:

OAI-PMH

Edition name Date
ZB-113636 Oct 14, 2019
×

Citation

Citation style:

This page uses 'cookies'. More information