Effects of exercise training on calf muscle oxygen extraction and blood flow in patients with peripheral artery disease

Wesley B. Baker, Zhe Li, Steven S. Schenkel, Malavika Chandra, David R. Busch, Erin K. Englund, Kathryn H. Schmitz, Arjun G. Yodh, Thomas F. Floyd, Emile R. Mohler

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

We employed near-infrared optical techniques, diffuse correlation spectroscopy (DCS), and frequency-domain nearinfrared spectroscopy (FD-NIRS) to test the hypothesis that supervised exercise training increases skeletal muscle microvascular blood flow and oxygen extraction in patients with peripheral artery disease (PAD) who experience claudication. PAD patients (n = 64) were randomly assigned to exercise and control groups. Patients in the exercise group received 3 mo of supervised exercise training. Calf muscle blood flow and oxygen extraction were optically monitored before, during, and after performance of a graded treadmill protocol at baseline and at 3 mo in both groups. Additionally, measurements of the ankle-brachial index (ABI) and peak walking time (PWT) to maximal claudication were made during each patient visit. Supervised exercise training was found to increase the maximal calf muscle blood flow and oxygen extraction levels during treadmill exercise by 29% (13%, 50%) and 8% (1%, 12%), respectively [P < 0.001; median (25th percentile, 75th percentile)]. These improvements across the exercise group population were significantly higher than corresponding changes in the control group (P < 0.004). Exercise training also increased PWT by 49% (18%, 101%) (P < 0.01). However, within statistical error, the ABI, resting calf muscle blood flow and oxygen extraction, and the recovery half-time for hemoglobin\myoglobin desaturation following cessation of maximal exercise were not altered by exercise training. The concurrent monitoring of both blood flow and oxygen extraction with the hybrid DCS/FD-NIRS instrument revealed enhanced muscle oxidative metabolism during physical activity from exercise training, which could be an underlying mechanism for the observed improvement in PWT. NEW & NOTEWORTHY We report on noninvasive optical measurements of skeletal muscle blood flow and oxygen extraction dynamics before/during/after treadmill exercise in peripheral artery disease patients who experience claudication. The measurements tracked the effects of a 3-mo supervised exercise training protocol and revealed that supervised exercise training improved patient ability to increase microvascular calf muscle blood flow and oxygen extraction during physical activity.

Original languageEnglish (US)
Pages (from-to)1599-1609
Number of pages11
JournalJournal of applied physiology
Volume123
Issue number6
DOIs
StatePublished - Dec 2017

Fingerprint

Peripheral Arterial Disease
Exercise
Oxygen
Muscles
Spectrum Analysis
Walking
Ankle Brachial Index
Skeletal Muscle
Control Groups
Myoglobin
Population Groups

All Science Journal Classification (ASJC) codes

  • Physiology
  • Physiology (medical)

Cite this

Baker, W. B., Li, Z., Schenkel, S. S., Chandra, M., Busch, D. R., Englund, E. K., ... Mohler, E. R. (2017). Effects of exercise training on calf muscle oxygen extraction and blood flow in patients with peripheral artery disease. Journal of applied physiology, 123(6), 1599-1609. https://doi.org/10.1152/japplphysiol.00585.2017
Baker, Wesley B. ; Li, Zhe ; Schenkel, Steven S. ; Chandra, Malavika ; Busch, David R. ; Englund, Erin K. ; Schmitz, Kathryn H. ; Yodh, Arjun G. ; Floyd, Thomas F. ; Mohler, Emile R. / Effects of exercise training on calf muscle oxygen extraction and blood flow in patients with peripheral artery disease. In: Journal of applied physiology. 2017 ; Vol. 123, No. 6. pp. 1599-1609.
@article{c52c67874762404d86bef8abaa2f8eac,
title = "Effects of exercise training on calf muscle oxygen extraction and blood flow in patients with peripheral artery disease",
abstract = "We employed near-infrared optical techniques, diffuse correlation spectroscopy (DCS), and frequency-domain nearinfrared spectroscopy (FD-NIRS) to test the hypothesis that supervised exercise training increases skeletal muscle microvascular blood flow and oxygen extraction in patients with peripheral artery disease (PAD) who experience claudication. PAD patients (n = 64) were randomly assigned to exercise and control groups. Patients in the exercise group received 3 mo of supervised exercise training. Calf muscle blood flow and oxygen extraction were optically monitored before, during, and after performance of a graded treadmill protocol at baseline and at 3 mo in both groups. Additionally, measurements of the ankle-brachial index (ABI) and peak walking time (PWT) to maximal claudication were made during each patient visit. Supervised exercise training was found to increase the maximal calf muscle blood flow and oxygen extraction levels during treadmill exercise by 29{\%} (13{\%}, 50{\%}) and 8{\%} (1{\%}, 12{\%}), respectively [P < 0.001; median (25th percentile, 75th percentile)]. These improvements across the exercise group population were significantly higher than corresponding changes in the control group (P < 0.004). Exercise training also increased PWT by 49{\%} (18{\%}, 101{\%}) (P < 0.01). However, within statistical error, the ABI, resting calf muscle blood flow and oxygen extraction, and the recovery half-time for hemoglobin\myoglobin desaturation following cessation of maximal exercise were not altered by exercise training. The concurrent monitoring of both blood flow and oxygen extraction with the hybrid DCS/FD-NIRS instrument revealed enhanced muscle oxidative metabolism during physical activity from exercise training, which could be an underlying mechanism for the observed improvement in PWT. NEW & NOTEWORTHY We report on noninvasive optical measurements of skeletal muscle blood flow and oxygen extraction dynamics before/during/after treadmill exercise in peripheral artery disease patients who experience claudication. The measurements tracked the effects of a 3-mo supervised exercise training protocol and revealed that supervised exercise training improved patient ability to increase microvascular calf muscle blood flow and oxygen extraction during physical activity.",
author = "Baker, {Wesley B.} and Zhe Li and Schenkel, {Steven S.} and Malavika Chandra and Busch, {David R.} and Englund, {Erin K.} and Schmitz, {Kathryn H.} and Yodh, {Arjun G.} and Floyd, {Thomas F.} and Mohler, {Emile R.}",
year = "2017",
month = "12",
doi = "10.1152/japplphysiol.00585.2017",
language = "English (US)",
volume = "123",
pages = "1599--1609",
journal = "Journal of Applied Physiology",
issn = "8750-7587",
publisher = "American Physiological Society",
number = "6",

}

Baker, WB, Li, Z, Schenkel, SS, Chandra, M, Busch, DR, Englund, EK, Schmitz, KH, Yodh, AG, Floyd, TF & Mohler, ER 2017, 'Effects of exercise training on calf muscle oxygen extraction and blood flow in patients with peripheral artery disease', Journal of applied physiology, vol. 123, no. 6, pp. 1599-1609. https://doi.org/10.1152/japplphysiol.00585.2017

Effects of exercise training on calf muscle oxygen extraction and blood flow in patients with peripheral artery disease. / Baker, Wesley B.; Li, Zhe; Schenkel, Steven S.; Chandra, Malavika; Busch, David R.; Englund, Erin K.; Schmitz, Kathryn H.; Yodh, Arjun G.; Floyd, Thomas F.; Mohler, Emile R.

In: Journal of applied physiology, Vol. 123, No. 6, 12.2017, p. 1599-1609.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of exercise training on calf muscle oxygen extraction and blood flow in patients with peripheral artery disease

AU - Baker, Wesley B.

AU - Li, Zhe

AU - Schenkel, Steven S.

AU - Chandra, Malavika

AU - Busch, David R.

AU - Englund, Erin K.

AU - Schmitz, Kathryn H.

AU - Yodh, Arjun G.

AU - Floyd, Thomas F.

AU - Mohler, Emile R.

PY - 2017/12

Y1 - 2017/12

N2 - We employed near-infrared optical techniques, diffuse correlation spectroscopy (DCS), and frequency-domain nearinfrared spectroscopy (FD-NIRS) to test the hypothesis that supervised exercise training increases skeletal muscle microvascular blood flow and oxygen extraction in patients with peripheral artery disease (PAD) who experience claudication. PAD patients (n = 64) were randomly assigned to exercise and control groups. Patients in the exercise group received 3 mo of supervised exercise training. Calf muscle blood flow and oxygen extraction were optically monitored before, during, and after performance of a graded treadmill protocol at baseline and at 3 mo in both groups. Additionally, measurements of the ankle-brachial index (ABI) and peak walking time (PWT) to maximal claudication were made during each patient visit. Supervised exercise training was found to increase the maximal calf muscle blood flow and oxygen extraction levels during treadmill exercise by 29% (13%, 50%) and 8% (1%, 12%), respectively [P < 0.001; median (25th percentile, 75th percentile)]. These improvements across the exercise group population were significantly higher than corresponding changes in the control group (P < 0.004). Exercise training also increased PWT by 49% (18%, 101%) (P < 0.01). However, within statistical error, the ABI, resting calf muscle blood flow and oxygen extraction, and the recovery half-time for hemoglobin\myoglobin desaturation following cessation of maximal exercise were not altered by exercise training. The concurrent monitoring of both blood flow and oxygen extraction with the hybrid DCS/FD-NIRS instrument revealed enhanced muscle oxidative metabolism during physical activity from exercise training, which could be an underlying mechanism for the observed improvement in PWT. NEW & NOTEWORTHY We report on noninvasive optical measurements of skeletal muscle blood flow and oxygen extraction dynamics before/during/after treadmill exercise in peripheral artery disease patients who experience claudication. The measurements tracked the effects of a 3-mo supervised exercise training protocol and revealed that supervised exercise training improved patient ability to increase microvascular calf muscle blood flow and oxygen extraction during physical activity.

AB - We employed near-infrared optical techniques, diffuse correlation spectroscopy (DCS), and frequency-domain nearinfrared spectroscopy (FD-NIRS) to test the hypothesis that supervised exercise training increases skeletal muscle microvascular blood flow and oxygen extraction in patients with peripheral artery disease (PAD) who experience claudication. PAD patients (n = 64) were randomly assigned to exercise and control groups. Patients in the exercise group received 3 mo of supervised exercise training. Calf muscle blood flow and oxygen extraction were optically monitored before, during, and after performance of a graded treadmill protocol at baseline and at 3 mo in both groups. Additionally, measurements of the ankle-brachial index (ABI) and peak walking time (PWT) to maximal claudication were made during each patient visit. Supervised exercise training was found to increase the maximal calf muscle blood flow and oxygen extraction levels during treadmill exercise by 29% (13%, 50%) and 8% (1%, 12%), respectively [P < 0.001; median (25th percentile, 75th percentile)]. These improvements across the exercise group population were significantly higher than corresponding changes in the control group (P < 0.004). Exercise training also increased PWT by 49% (18%, 101%) (P < 0.01). However, within statistical error, the ABI, resting calf muscle blood flow and oxygen extraction, and the recovery half-time for hemoglobin\myoglobin desaturation following cessation of maximal exercise were not altered by exercise training. The concurrent monitoring of both blood flow and oxygen extraction with the hybrid DCS/FD-NIRS instrument revealed enhanced muscle oxidative metabolism during physical activity from exercise training, which could be an underlying mechanism for the observed improvement in PWT. NEW & NOTEWORTHY We report on noninvasive optical measurements of skeletal muscle blood flow and oxygen extraction dynamics before/during/after treadmill exercise in peripheral artery disease patients who experience claudication. The measurements tracked the effects of a 3-mo supervised exercise training protocol and revealed that supervised exercise training improved patient ability to increase microvascular calf muscle blood flow and oxygen extraction during physical activity.

UR - http://www.scopus.com/inward/record.url?scp=85038620485&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038620485&partnerID=8YFLogxK

U2 - 10.1152/japplphysiol.00585.2017

DO - 10.1152/japplphysiol.00585.2017

M3 - Article

C2 - 28982943

AN - SCOPUS:85038620485

VL - 123

SP - 1599

EP - 1609

JO - Journal of Applied Physiology

JF - Journal of Applied Physiology

SN - 8750-7587

IS - 6

ER -