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 This type of pain comes from intermittent claudication, when too
little blood reaches the muscles, and it is usually a sign that
blood vessels in the legs are clogged by atherosclerosis, a
condition known as peripheral artery disease.
Research shows that a supervised exercise program can help, and
should be the first treatment tried, a group of exercise and
rehabilitation experts writes in a new infographic.
If a supervised program isn't available, patients can follow a
walk-rest-walk pattern on their own, which the authors illustrate in
the British Journal of Sports Medicine.
"The condition is underdiagnosed and undertreated despite it being
common and associated with mobility limitation and an increased risk
of heart attack, stroke, amputation and death," said coauthor Garry
Tew of Northumbria University in Newcastle, UK.
"The public is not well informed about peripheral artery disease or
its main symptom of intermittent claudication," Tew told Reuters
Health by email. "Clinical guidelines recommend exercise as a
first-line approach."
Intermittent claudication affects about 4% of people over age 60 and
is the most common symptom of peripheral artery disease, according
to the UK's National Institute for Health and Care Excellence
(NICE). It leads to impaired quality of life and increased risk of
death from heart attack and stroke.
NICE guidelines recommend a three-month supervised exercise program
to reduce pain, improve heart health, boost mood, improve sleep,
maintain a healthy weight and ultimately lower the need for vascular
procedures on the legs, such as clearing blood vessels and placing a
stent.
Supervised exercise classes have shown the greatest benefits, the
authors write, and patients should feel comfortable asking their
doctor what's available locally.
"There is good quality research evidence showing that it can improve
walking ability and quality of life," Tew said. "Some types of
exercise are more effective than others, so it is useful to
highlight the type that will benefit patients the most."
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If a program isn't available, patients can exercise on their own, alternating
between walking for 3 to 10 minutes until moderate-to-strong pain develops,
resting until the pain subsides, and then walking for 3 to 10 minutes again.
Patients should aim to complete 30-60 minutes of walking per session, according
to the infographic, and three to five sessions per week. On at least two days
per week, they should also incorporate strength and balance activities, such as
yoga, dance, tai chi, bowling or lifting weights at a gym.
The experts also recommend wearing comfortable clothing and staying hydrated. In
addition, they say, choose walking routes with resting places, exercise with
others and build in variety to keep the walking routine fun. Of course, don't
exercise if unwell, and seek medical advice if chest pain, dizziness or sickness
occurs during walking.
Overall, the exercise researchers write, don't fear walking with leg pain, and
build up the walking speed and time gradually. It typically takes several weeks
of exercise to improve symptoms.
"It may take a while to achieve significant improvements after you have started
exercising or walking, so be patient," said Ukachukwu Abaraogu of Glasgow
Caledonian University in the UK. Abaraogu, who wasn't involved with the
infographic, researches intermittent claudication and chronic diseases.
"Be intentional about exercising and aim to do it for 30-60 minutes per day
several times a week," he told Reuters Health by email. "But do not be afraid to
start, even if you cannot achieve this at the beginning."
SOURCE: https://bit.ly/2PspCGb British Journal of Sports Medicine, online
February 12, 2020.
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