The ischemic window

A method for the objective quantitation of the training effect in exercise therapy for intermittent claudication

Richard L. Feinberg, Roger T. Gregory, Jock R. Wheeler, Stanley O. Snyder, Robert G. Gayle, F. Noel Parent, Robert B. Patterson

Research output: Contribution to journalArticle

Abstract

Twenty-two patients with intermittent claudication were prospectively enrolled in a 12-week program of supervised, graded treadmill exercise therapy. Severity and distribution of arterial occlusive disease were ascertained by noninvasive determination of segmental lower extremity blood pressures and waveforms. No attempt was made to modify risk factors for atherosclerotic occlusive disease. The exercise-induced reduction of the ankle pressure and its recovery were recorded over time, and the area under this curve, the "ischemic window," represents the severity of the ischemic deficit. Absolute systolic ankle pressure, ankle-brachial index, maximum walking time, claudication pain time, and the ischemic window were measured before and after exercise training in all subjects. Maximum walking time and claudication pain time increased 659% and 846%, respectively, among the 19 patients completing the 12-week program (p = 0.001; p = 0.0002). These patients underwent a mean reduction of 58.7% in the ischemic window after a standardized workload (p <0.05), and this correlated with the degree of symptomatic improvement. Absolute ankle pressure and ankle-brachial index were unchanged after exercise training. This study confirms the utility of supervised exercise therapy in the treatment of intermittent claudication. The ischemic window is a useful method for quantifying the ischemic deficit produced by exercise and provides a reproducible means of documenting functional improvement in patients undergoing exercise training.

Original languageEnglish (US)
Pages (from-to)244-250
Number of pages7
JournalJournal of Vascular Surgery
Volume16
Issue number2
DOIs
StatePublished - 1992
Externally publishedYes

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Exercise Therapy
Intermittent Claudication
Exercise
Ankle
Ankle Brachial Index
Walking
Blood Pressure
Pressure
Pain
Arterial Occlusive Diseases
Workload
Area Under Curve
Lower Extremity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Feinberg, R. L., Gregory, R. T., Wheeler, J. R., Snyder, S. O., Gayle, R. G., Parent, F. N., & Patterson, R. B. (1992). The ischemic window: A method for the objective quantitation of the training effect in exercise therapy for intermittent claudication. Journal of Vascular Surgery, 16(2), 244-250. https://doi.org/10.1016/0741-5214(92)90114-N

The ischemic window : A method for the objective quantitation of the training effect in exercise therapy for intermittent claudication. / Feinberg, Richard L.; Gregory, Roger T.; Wheeler, Jock R.; Snyder, Stanley O.; Gayle, Robert G.; Parent, F. Noel; Patterson, Robert B.

In: Journal of Vascular Surgery, Vol. 16, No. 2, 1992, p. 244-250.

Research output: Contribution to journalArticle

Feinberg, Richard L. ; Gregory, Roger T. ; Wheeler, Jock R. ; Snyder, Stanley O. ; Gayle, Robert G. ; Parent, F. Noel ; Patterson, Robert B. / The ischemic window : A method for the objective quantitation of the training effect in exercise therapy for intermittent claudication. In: Journal of Vascular Surgery. 1992 ; Vol. 16, No. 2. pp. 244-250.
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