Physical activity and peripheral atherosclerosis.

Abstract

This article describes changes in the muscular blood flow and metabolism in intermittent claudication (pain in the legs during physical work) and the effect of physical training on these factors. The disease (arteriosclerosis obliterans) is characterized by a reduction in the blood flow through muscles and in oxygen uptake, together with increased lactate excretion during work, usually in spite of a developed arterial collateral system. An increased ability to extract oxygen from the blood while the affected muscle metabolism is modified in the direction of greater aerobic capacity can partially compensate for the reduction in blood perfusion. Physical activity which involves large muscle groups and is continued beyond the boundary of pain leads to an increase in both claudication distance (the distance until pain appears during normal walking on the flat) and the walking distance (maximal distance the patient can walk). Since the blood flow is unchanged or reduced, the effect seems not to be due to improved vascular capacity. It has however been shown that training gives rise to further increase both in the ability to extract oxygen from the blood and in the metabolic activity of muscle tissue. It is concluded that, if indications for surgical treatment are not present, training by walking with regular controls constitutes good treatment favourable to health economics and able to improve the patient's quality of life.