July 15, 2016

Aluísio Lima1, Raphael Ritti-Dias1, Cláudia L.M. Forjaz2, Marilia Correia1, Alessandra Miranda1, Maria Brasileiro-Santos3, Amilton Santos3, Dario Sobral Filho4, & Alexandre Silva3

1 School of Physical Education, University of Pernambuco, Rua Arnóbio Marques, 310, Recife, Pernambuco 50.100-130, Brazil.
2 Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.
3 Department of Physical Education, University Federal of Paraíba, Paraíba, Brazil.
4 Procape University Hospital, University of Pernambuco, Pernambuco, Brazil.

The importance of monitoring and maintaining the balance between training stimulus and recovery in all athletes is vital to optimize positive adaptation. However, the combative nature and unpredictable stress imposed on an individual Canadian football player presents a unique monitoring challenge especially when interpreting fatigue measures.Peripheral artery disease affects between 3 and 10% of the general population and more than 20% of the population older than 70 years of age, with at least 200 million people worldwide (Selvin and Erlinger 2004). Moreover, this disease is associated with several cardiac and vascular problems, increasing the cardiovascular risk of these individuals (Weitz et al. 1996). The main symptom of peripheral artery disease is intermittent claudication, which limits walking capacity (Munger and Hawkins 2004). Patients with these symptoms feel pain in the lower limbs during effort in their daily routine, due to arterial occlusion. Lifestyle modifications including smoking cessation and physical activity practice are recommended to improve walking capacity and control cardiovascular risk factors in patients with peripheral artery disease (Munger and Hawkins 2004). In fact, resistance exercise programs have shown to improve patients walking capacity (Ritti-Dias et al. 2010), but their effects on cardiovascular function are poorly understood.

In this study, 14 patients with peripheral artery disease and claudication symptoms performed two sessions on different days: control (rest for 30 min) and resistance exercise. In the resistance exercise session the patients completed 8 exercises (bench press, 45° leg press, seated row, knee extension, frontal rise, knee curl, elbow curl, and hip abduction) with 2 sets of 10 repetitions at an intensity of 5–7 in the OMNI Resistance Exercise Scale (perceived exertion scale). Before and 40 min after the interventions the blood flow and post-occlusive hyperemia were measured. The results indicated that a single session of resistance exercise promoted vascular benefits acutely improving the patient´s blood flow in their legs. Since reduced blood flow is a marker of morbidity and mortality in these patients (Corrado et al. 2008), the practical message is that resistance exercise may provide benefits for these patients if these responses are reproduced after chronic training. Considering that previous studies showed that resistance exercise improves walking capacity (Ritti-Dias et al. 2010), quality of life (McDermott et al. 2009) and muscle strength (Ritti-Dias et al. 2010) of patients with peripheral artery disease, we recommend this mode of exercise for peripheral artery disease patients.


Corrado, E., Rizzo, M., Coppola, G., Muratori, I., Carella, M. and Novo, S. 2008. Endothelial dysfunction and carotid lesions are strong predictors of clinical events in patients with early stages of atherosclerosis: a 24-month follow-up study. Coron Artery Dis. 19 (3): 139-44.

McDermott, M.M., Ades, P., Guralnik, J.M., Dyer, A., Ferrucci, L., Liu, K., et al. 2009. Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial. JAMA. 301 (2): 165-74.

Munger, M.A. and Hawkins, D.W. 2004. Atherothrombosis: epidemiology, pathophysiology, and prevention. J Am Pharm Assoc (2003). 44 (2 Suppl 1): S5-12; quiz S12-3.

Ritti-Dias, R.M., Wolosker, N., de Moraes Forjaz, C.L., Carvalho, C.R., Cucato, G.G., Leao, P.P., et al. 2010. Strength training increases walking tolerance in intermittent claudication patients: randomized trial. J Vasc Surg. 51 (1): 89-95.

Selvin, E. and Erlinger, T.P. 2004. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation. 110 (6): 738-43.

Weitz, J.I., Byrne, J., Clagett, G.P., Farkouh, M.E., Porter, J.M., Sackett, D.L., et al. 1996. Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical review. Circulation. 94 (11): 3026-49.

This article is a summary of an article published in Applied Physiology, Nutrition & Metabolism. If you intend citing any information in this article, please consult the original article and cite that source. This summary was written for the Canadian Society for Exercise Physiology and it has been reviewed by the CSEP Knowledge Translation Committee.

Original Article

Lima, A., Ritti-Dias, R., Forjaz, CL., Correia, M., Miranda, A., Brasileiro-Santos, M., Santos, A., Sobral Filho, D., Silva, A. 2015. A session of resistance exercise increases vasodilation in intermittent claudication patients. Appl. Physiol. Nutr. Metab. 40 (1): 59-64.