{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T03:57:10Z","timestamp":1774497430205,"version":"3.50.1"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n            <jats:title>Purpose:<\/jats:title>\n            <jats:p>To compare arm-ergometry and treadmill supervised exercise training on cardiorespiratory fitness and walking distances in patients with peripheral artery disease (PAD).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>ARMEX was a single-center, single-blinded, parallel group, non-inferiority trial enrolling symptomatic patients with PAD. Patients were randomized (1:1 ratio) to a 12-wk arm-ergometry (AEx) or standard treadmill (TEx) supervised exercise training protocol. The powered primary end point was the change in peak oxygen uptake (VO<jats:sub>2<\/jats:sub>) at 12 wk, measured on a treadmill cardiopulmonary exercise test (CPX). Secondary outcomes included changes in VO<jats:sub>2<\/jats:sub> at the first ventilatory threshold (VT-1), ventilatory efficiency (ratio of minute ventilation [VE] to carbon dioxide production [VCO<jats:sub>2<\/jats:sub>], VE\/VCO<jats:sub>2<\/jats:sub>), walking distances by CPX and 6-min walking test (6MWT), and self-reported walking limitations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Fifty-six patients (66\u00a0\u00b1\u00a08\u00a0yr; 88% male) were randomized (AEx, n =\u00a028; TEx, n =\u00a028). At 12 wk, VO<jats:sub>2peak<\/jats:sub> change was not significantly different between groups (0.75 mL\/kg\/min; 95% CI, \u22120.94 to 2.44; <jats:italic toggle=\"yes\">P<\/jats:italic> =\u00a0.378), despite a significant increase only in AEx. VO<jats:sub>2<\/jats:sub> at VT-1 improved in both groups without between-group differences, and VE\/VCO<jats:sub>2<\/jats:sub> slope improved more in AEx. The TEx attained greater improvements in walking distance by CPX (121.08 m; 95% CI, 24.49-217.66; <jats:italic toggle=\"yes\">P<\/jats:italic> =\u00a0.015) and 6MWT (25.08 m; 95% CI, 5.87-44.29; <jats:italic toggle=\"yes\">P<\/jats:italic> =\u00a0.012) and self-perceived walking distance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Arm-ergometry was noninferior to standard treadmill training for VO<jats:sub>2peak<\/jats:sub>, and treadmill training was associated with greater improvements in walking distance. Our data support the use of treadmill as a first-line choice in patients with PAD to enhance walking capacity, but arm-ergometry could be an option in selected patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/hcr.0000000000000878","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T16:00:10Z","timestamp":1720800010000},"page":"353-360","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Effect of Arm-Ergometry Versus Treadmill Supervised Exercise on Cardiorespiratory Fitness and Walking Distances in Patients With Peripheral Artery Disease"],"prefix":"10.1097","volume":"44","author":[{"given":"Sandra","family":"Magalh\u00e3es","sequence":"first","affiliation":[]},{"given":"M\u00e1rio","family":"Santos","sequence":"additional","affiliation":[]},{"given":"Sofia","family":"Viamonte","sequence":"additional","affiliation":[]},{"given":"Fernando","family":"Ribeiro","sequence":"additional","affiliation":[]},{"given":"Joana","family":"Martins","sequence":"additional","affiliation":[]},{"given":"Cristine","family":"Schmidt","sequence":"additional","affiliation":[]},{"given":"Daniel","family":"Martinho-Dias","sequence":"additional","affiliation":[]},{"given":"Henrique","family":"Cyrne-Carvalho","sequence":"additional","affiliation":[]}],"member":"276","published-online":{"date-parts":[[2024,9,3]]},"reference":[{"issue":"8","key":"R1-20250528","doi-asserted-by":"crossref","first-page":"e1020","DOI":"10.1016\/S2214-109X(19)30255-4","article-title":"Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and analysis","volume":"7","author":"Song","year":"2019","journal-title":"Lancet Glob Health"},{"issue":"4","key":"R2-20250528","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.ejvs.2018.01.019","article-title":"Ten year mortality in different peripheral arterial disease stages: a population based observational study on outcome","volume":"55","author":"Sartipy","year":"2018","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"4","key":"R3-20250528","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1161\/CIR.0000000000000623","article-title":"Optimal exercise programs for patients with peripheral artery disease: a scientific statement from the American Heart Association","volume":"139","author":"Treat-Jacobson","year":"2019","journal-title":"Circulation"},{"issue":"12","key":"R4-20250528","first-page":"e686","article-title":"2016 AHA\/ACC guideline on the management of patients with lower extremity peripheral artery disease: executive summary","volume":"135","author":"Gerhard-Herman","year":"2017","journal-title":"Circulation"},{"issue":"Suppl S","key":"R5-20250528","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/j.jvs.2006.12.037","article-title":"Inter-society consensus for the management of peripheral arterial disease (TASC II)","volume":"45","author":"Norgren","year":"2007","journal-title":"J Vasc Surg"},{"issue":"15","key":"R6-20250528","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1177\/2047487319846997","article-title":"Completion and adherence rates to exercise interventions in intermittent claudication: traditional exercise versus alternative exercise\u2014a systematic review","volume":"26","author":"Lin","year":"2019","journal-title":"Eur J Prev Cardiol"},{"issue":"8","key":"R7-20250528","first-page":"CD009638","article-title":"Modes of exercise training for intermittent claudication","volume":"8","author":"Jansen","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"R8-20250528","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s40279-014-0261-z","article-title":"Exercise training for management of peripheral arterial disease: a systematic review and meta-analysis","volume":"45","author":"Parmenter","year":"2015","journal-title":"Sports Med"},{"issue":"1","key":"R9-20250528","doi-asserted-by":"crossref","first-page":"40","DOI":"10.7326\/M17-0046","article-title":"CONSORT statement for randomized trials of nonpharmacologic treatments: a 2017 update and a CONSORT extension for nonpharmacologic trial abstracts","volume":"167","author":"Boutron","year":"2017","journal-title":"Ann Intern Med"},{"issue":"5","key":"R10-20250528","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1177\/2047487320913379","article-title":"Secondary prevention through comprehensive cardiovascular rehabilitation: from knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology","volume":"28","author":"Ambrosetti","year":"2021","journal-title":"Eur J Prev Cardiol"},{"issue":"24","key":"R11-20250528","doi-asserted-by":"crossref","first-page":"e653","DOI":"10.1161\/CIR.0000000000000461","article-title":"Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association","volume":"134","author":"Ross","year":"2016","journal-title":"Circulation"},{"issue":"5","key":"R12-20250528","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.ejvs.2007.12.007","article-title":"Effect of upper- and lower-limb exercise training on circulating soluble adhesion molecules, hs-CRP and stress proteins in patients with intermittent claudication","volume":"35","author":"Saxton","year":"2008","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"6","key":"R13-20250528","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1016\/j.jvs.2005.08.021","article-title":"Upper- vs lower-limb aerobic exercise rehabilitation in patients with symptomatic peripheral arterial disease: a randomized controlled trial","volume":"42","author":"Zwierska","year":"2005","journal-title":"J Vasc Surg"},{"issue":"2","key":"R14-20250528","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jvs.2007.10.038","article-title":"Effects of a long-term exercise program on lower limb mobility, physiological responses, walking performance, and physical activity levels in patients with peripheral arterial disease","volume":"47","author":"Crowther","year":"2008","journal-title":"J Vasc Surg"},{"issue":"1","key":"R15-20250528","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1111\/j.1475-097X.2007.00770.x","article-title":"Randomized controlled trial of supervised exercise to evaluate changes in cardiac function in patients with peripheral atherosclerotic disease","volume":"28","author":"Hodges","year":"2008","journal-title":"Clin Physiol Funct Imaging"},{"issue":"6","key":"R16-20250528","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/j.jvs.2011.01.077","article-title":"Comparison of the effect of upper body ergometry aerobic training vs treadmill training on central cardiorespiratory improvement and walking distance in patients with claudication","volume":"53","author":"Bronas","year":"2011","journal-title":"J Vasc Surg"},{"issue":"6","key":"R17-20250528","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/j.freeradbiomed.2010.06.033","article-title":"Plasma nitrite flux predicts exercise performance in peripheral arterial disease after 3 months of exercise training","volume":"49","author":"Allen","year":"2010","journal-title":"Free Radic Biol Med"},{"key":"R18-20250528","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1177\/1358863X18762599","article-title":"Minimal clinically important differences in treadmill, 6-minute walk, and patient-based outcomes following supervised and home-based exercise in peripheral artery disease","volume":"23","author":"Gardner","year":"2018","journal-title":"Vasc Med"},{"issue":"4","key":"R19-20250528","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1024\/0301-1526\/a000203","article-title":"Ventilatory threshold is related to walking tolerance in patients with intermittent claudication","volume":"41","author":"da Rocha Chehuen","year":"2012","journal-title":"Vasa"},{"issue":"6","key":"R20-20250528","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1016\/j.jvs.2018.10.065","article-title":"Cardiovascular and musculoskeletal response to supervised exercise in patients with intermittent claudication","volume":"69","author":"Harwood","year":"2019","journal-title":"J Vasc Surg"},{"issue":"12","key":"R21-20250528","first-page":"CD000990","article-title":"Exercise for intermittent claudication","volume":"12","author":"Lane","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"R22-20250528","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.atherosclerosis.2015.02.038","article-title":"Upper versus lower limb exercise training in patients with intermittent claudication: a systematic review","volume":"239","author":"Tompra","year":"2015","journal-title":"Atherosclerosis"},{"issue":"3","key":"R23-20250528","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1177\/1358863X08101858","article-title":"Efficacy of arm-ergometry versus treadmill exercise training to improve walking distance in patients with claudication","volume":"14","author":"Treat-Jacobson","year":"2009","journal-title":"Vasc Med"},{"issue":"3","key":"R24-20250528","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1016\/j.jvs.2019.05.058","article-title":"Comparing 6-minute walk versus treadmill walking distance as outcomes in randomized trials of peripheral artery disease","volume":"71","author":"McDermott","year":"2020","journal-title":"J Vasc Surg"},{"issue":"5","key":"R25-20250528","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/j.jvs.2010.10.125","article-title":"Upper-versus lower-limb aerobic exercise training on health-related quality of life in patients with symptomatic peripheral arterial disease","volume":"53","author":"Saxton","year":"2011","journal-title":"J Vasc Surg"},{"issue":"1","key":"R26-20250528","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1177\/1358863X14559092","article-title":"Exercise training for health-related quality of life in peripheral artery disease: a systematic review and meta-analysis","volume":"20","author":"Parmenter","year":"2015","journal-title":"Vasc Med"},{"issue":"1","key":"R27-20250528","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jvs.2008.12.073","article-title":"The walking impairment questionnaire: an effective tool to assess the effect of treatment in patients with intermittent claudication","volume":"50","author":"Nicola\u00ef","year":"2009","journal-title":"J Vasc Surg"},{"issue":"3","key":"R28-20250528","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1161\/CIRCOUTCOMES.111.000070","article-title":"Walking impairment questionnaire improves mortality risk prediction models in a high-risk cohort independent of peripheral arterial disease status","volume":"6","author":"Nead","year":"2013","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"3","key":"R29-20250528","first-page":"355","article-title":"Effects of upper body exercise training on aerobic fitness and performance in healthy people: a systematic review","volume":"12","author":"Marterer","year":"2023","journal-title":"Biology (Basel)"},{"issue":"12","key":"R30-20250528","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1042\/CS20080688","article-title":"Limb-specific and cross-transfer effects of arm-crank exercise training in patients with symptomatic peripheral arterial disease","volume":"117","author":"Tew","year":"2009","journal-title":"Clin Sci (Lond)"},{"issue":"2","key":"R31-20250528","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1161\/01.CIR.81.2.602","article-title":"Benefit of exercise conditioning for patients with peripheral arterial disease","volume":"81","author":"Hiatt","year":"1990","journal-title":"Circulation"},{"issue":"4","key":"R32-20250528","doi-asserted-by":"crossref","first-page":"1866","DOI":"10.1161\/01.CIR.90.4.1866","article-title":"Superiority of treadmill walking exercise versus strength training for patients with peripheral arterial disease. Implications for the mechanism of the training response","volume":"90","author":"Hiatt","year":"1994","journal-title":"Circulation"},{"issue":"1","key":"R33-20250528","doi-asserted-by":"crossref","first-page":"e009380","DOI":"10.1161\/JAHA.118.009380","article-title":"Durability of benefits from supervised treadmill exercise in people with peripheral artery disease","volume":"8","author":"McDermott","year":"2019","journal-title":"J Am Heart Assoc"},{"issue":"6","key":"R34-20250528","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1016\/j.jvs.2004.01.034","article-title":"Long-term results of peripheral arterial disease rehabilitation","volume":"39","author":"Menard","year":"2004","journal-title":"J Vasc Surg"},{"issue":"4","key":"R35-20250528","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1249\/00005768-198408000-00007","article-title":"Physiological responses to prolonged upper-body exercise","volume":"16","author":"Pimental","year":"1984","journal-title":"Med Sci Sports Exerc"},{"issue":"2","key":"R36-20250528","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.ejvs.2005.06.025","article-title":"Relative tolerance to upper- and lower-limb aerobic exercise in patients with peripheral arterial disease","volume":"31","author":"Zwierska","year":"2006","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"2","key":"R37-20250528","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1152\/japplphysiol.00612.2003","article-title":"Pulmonary V\u0307o2 dynamics during treadmill and arm exercise in peripheral arterial disease","volume":"97","author":"Bauer","year":"2004","journal-title":"J Appl Physiol (1985)"},{"issue":"2","key":"R38-20250528","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1177\/1358863X211072913","article-title":"Minimal clinically important differences in daily physical activity outcomes following supervised and home-based exercise in peripheral artery disease","volume":"27","author":"Gardner","year":"2022","journal-title":"Vasc Med"}],"container-title":["Journal of Cardiopulmonary Rehabilitation and Prevention"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/HCR.0000000000000878","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T21:26:33Z","timestamp":1748467593000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/HCR.0000000000000878"}},"subtitle":["The ARMEX Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/hcr.0000000000000878","relation":{},"ISSN":["1932-7501","1932-751X"],"issn-type":[{"value":"1932-7501","type":"print"},{"value":"1932-751X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]}}}