Rationale for Graded Exercise

The following factors related to the body’s normal response to exercise are the basis for using a graded exercise program to improve the functional status of patients with chronic arterial insufficiency.

· Blood flow temporarily decreases during active contraction of a muscle, but the blood flow rapidly increases immediately after the contraction.

· After cessation of exercise, there is a rapid decrease in blood flow during the first 3 to 4 minutes. This is followed by a slow decline to resting levels within 15 minutes.

· With repeated moderate-level exercise, blood flow in muscles can be increased beyond the resting values for blood flow.

Exercise Guidelines

· The patient should be encouraged to walk or bicycle as far as possible to a predetermined maximum target heart rate but without causing intermittent claudication.

· The graded endurance exercise should be carried out 3 to 5 days per week.

· The patient should perform mild warm-up and stretching activities prior to initiating walking or bicycling. Warm-up activities could include active pumping exercises of the ankle and toes.

Precautions and Contraindications for a Walking Program for Patients with Chronic Arterial Insufficiency

Precautions

· Avoid exercising outside during very cold weather.

· Wear shoes that fit properly, have sufficient padding, and do not cause skin irritation.

· Inspect the feet carefully for evidence of skin irritation after each exercise session.

· Discontinue a walking program if leg pain increases rather than decreases over time.

Contraindications

· Presence of skin irritation, an ulceration, a wound, or a fungal infection of the feet

· Leg pain at rest due to advanced vascular disease

Buy the Book that holds this excerpt: Therapeutic Exercise: Foundations and Techniques (Therapeutic Exercise: Foundations & Techniques)

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