Upper- versus lower-limb aerobic exercise training on health-related quality of life in patients with symptomatic peripheral arterial disease.

OBJECTIVE: This randomized controlled trial investigated the effects of upper- and lower-limb aerobic exercise training on disease-specific functional status and generic health-related quality of life (QOL) in patients with intermittent claudication. METHODS: The study recruited 104 patients (mean age, 68 years; range, 50-85) from the Sheffield Vascular Institute. Patients were randomly allocated to groups that received upper-limb (ULG) or lower-limb (LLG) aerobic exercise training, or to a nonexercise control group. Exercise was performed twice weekly for 24 weeks at equivalent limb-specific relative exercise intensities. Main outcome measures were scores on the Walking Impairment Questionnaire (WIQ) for disease-specific functional status, the Medical Outcomes Study Short Form version 2 (SF-36v2), and European Quality of Life Visual Analog Scale (EQ-VAS) for health-related QOL. Outcomes were assessed at baseline, and at 6, 24, 48, and 72 weeks. RESULTS: After 6 weeks, improvements in the perceived severity of claudication (P = .023) and stair climbing ability (P = .011) vs controls were observed in the ULG, and an improvement in the general health domain of the SF-36v2 vs controls was observed in the LLG (P = .010). After 24 weeks, all four WIQ domains were improved in the ULG vs controls (P ≤ .05), and three of the four WIQ domains were improved in the LLG (P < .05). After 24 to 72 weeks of follow-up, more consistent changes in generic health-related QOL domains were apparent in the ULG. CONCLUSIONS: These findings support the use of alternative, relatively pain-free forms of exercise in the clinical management of patients with intermittent claudication.

Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial.

OBJECTIVE: To investigate the effects of supervised aerobic exercise (AE) and a combined program of supervised aerobic, muscle strengthening, and flexibility exercises (combined exercise [CE]) on important health outcomes in women with fibromyalgia syndrome (FMS). DESIGN: Randomized controlled trial. SETTING: Community-based supervised intervention. PARTICIPANTS: Women (N=64) with a diagnosis of FMS according to the American College of Rheumatology criteria. INTERVENTION: Participants were randomly allocated to 1 of 3 groups: supervised AE, supervised CE, or usual-care control. Exercise sessions were performed twice weekly (45-60min/session) for 24 weeks. MAIN OUTCOME MEASURES: The primary outcome measure was the Fibromyalgia Impact Questionnaire (FIQ). Exploratory outcome measures were the 36-Item Short-Form Health Survey, Beck Depression Inventory (BDI), aerobic capacity (6-minute walk test), hand-grip strength, and range of motion in the shoulders and hips. RESULTS: Compliance with both interventions was excellent, with women in the exercise groups attending more than 85% of sessions. A 14% to 15% improvement from baseline in total FIQ score was observed in the exercise groups (P≤.02) and was accompanied by decreases in BDI scores of 8.5 (P<.001) and 6.4 (P<.001) points in the AE and CE groups, respectively. Relative to nonexercising controls, CE evoked improvements in the SF-36 Physical Functioning (P=.003) and Bodily Pain (P=.003) domains and was more effective than AE for evoking improvements in the Vitality (P=.002) and Mental Health (P=.04) domains. Greater improvements also were observed in shoulder/hip range of motion and handgrip strength in the CE group. CONCLUSION: Given the equivalent time commitment required for AE and CE, our results suggest that women with FMS can gain additional health benefits by engaging in a similar volume of CE.