[Effects of physical exercise and indobufen in patients with intermittent claudication. Results after a 2-year follow-up]. / Effetto dell'esercizio fisico e dell'indobufene nei pazienti affetti da claudicazione intermittente. Risultati dopo 2 anni di follow-up.

The study included 18 patients suffering from intermittent claudication before (stage 1) and after (stage 2) 3 months of rehabilitative training and after 2 years of follow-up (stage 3) during which patients undertook regular exercise (walking for 1 hour 3-4 days a week) and antiplatelet aggregating therapy with indobufen (200 mg x 2/day). A comparison of the data revealed that:a) there was a significant and gradual increase in the claudication pain distance (CPD) and maximal walking distance (MWD), and a reduced recovery time between stages 1 and 3 (parameters were assessed during and after walking on a treadmill (rolling mat) at a speed of 3.2 Km/h on a 12% slope); b) the resting ankle/arm pressure ratio was unchanged, but a significant increase was observed when the ratio was measured after exercise between stages 1 and 3; c) fibrinogenemia was significantly reduced between stages 1 and 2. Out of 18 subjects studied, 8 exceeded an MWD of 640 metres (maximum limit of exercise test which was suspended after 12'), 3 became asymptomatic, and 1 showed a significantly reduced capacity to walk. The paper concludes that, although it is necessary to obtain a confirmation from controlled studies, indobufen therapy and regular physical exercise represent an efficacious therapeutic approach, even over a long-term period, to stage II chronic arteriopathies of the lower limbs.

Evaluation of non-invasive haemodynamic parameters in patients with intermittent claudication subjected to physical training.

In a group of 26 patients, all smokers (mean age 56.9 +/- 8 years), with intermittent claudication due to arterial obliterative disease. We investigated some of the haemodynamic, haematologic and clinical parameters before and after a 3 months physical training program. During the training period, none of the patients were given vasoactive, anticoagulant, antiaggregant or other drugs which could affect blood lipid. Patients were instructed to walk for a minimum period of 1 hour daily, in addition to normal everyday activities. Statistically significant differences of claudication pain distance were obtained: 177 +/- 88 m vs 107 +/- 40 m, +65% (p less than 0.001); maximal walking distance: 456 +/- 205 m vs 250 +/- 138 m, +82% (p less than 0.0001) determined during treadmill test at 2 mph up 12% and t/2 peak flow: 30 +/- 11.6 sec vs 46.3 +/- 32.3 sec (p less than 0.02), determinated with plethysmographic venous occlusion strain-gauges studies. An important, but not significant decrease of fibrinogen was obtained: 302 +/- 60 mg% vs 328 +/- 57 (p = 0.06), whereas no statistically significant differences were found for the more important haemodynamic parameters: (1) Widsor index determinated before (60 +/- 14% vs 58 +/- 15%) and after (26 +/- 17% vs 26 +/- 17%) treadmill-test with Doppler ultrasound; (2) peak-flow (10.5 +/- 2 ml/100/min vs 10.2 +/- 3); (3) time to peak-flow (17 +/- 10.5 sec vs 19.3 +/- 12.1). We also didn't find any significant differences in total cholesterol (227 +/- 53 mg% vs 228 +/- 48) and haematocrit (43.6 +/- 3.5% vs 43.5 +/- 3.1).(ABSTRACT TRUNCATED AT 250 WORDS)