| 제목 |
The value of unilateral weight training for peripheral vascular disease. |
| 소속 |
Kwangju Christian Hospital, Department of Rehabilitation Medicine1 |
| 저자 |
Dong Youl Lee1*, Ji Hong Cheon1, Nana Lim1, Geun Su Lee1, Youn Kyung Cho1, Sung Hoon Lee1, Hyun Kyung Lee1† |
[Introduction]
Forty-three-year-old male patient was diagnosed with Klippel-Trénaunay syndrome and port-wine stain and Rt. spascitic hemiplegia was remarkable from his birth. He was hospitalized to our hospital because of tightness and claudication of right lower extremity which is getting worse recently. There was no abnormal findings from laboratory study and other various examination. But ABI-index was 0.96 on the left side and 1.31 on the right ABI-index by checking vascular insufficiency of lower limb and side to side difference of the lower limbs SBP was about 42. We performed infrared thermography due to the prominent temperature difference of lower legs, we could find out that the temperature of the right lower limb was 2.04 lower than that of the left.
Fig.1
Klippel-Trénaunay syndrome is a rare disease which is accompanied with pathologic vascular malformation and it has distinctive characteristics that varicosities of unusual distribution, unilateral soft and skeletal tissue hypertrophy, and usually the lower extremity involved. It is usual for peripheral vascular disease patients that ischemic pain during physical activity is as a result of a mismatch between active muscle oxygen supply and demand, also the symptoms typically disappear on cessation of exercise.
[methods]
We planned rehabilitation therapy that improves lower extremity function by increasing physical activity of affected limb. Heavy resistance training was performed by fastening 1.3kg sandbag - 4×10 repetitions at 50% of 1RM for knee extension - around right ankle and moderate-intensity aerobic exercise supplemented by resistance training at 60%-80%I-RM with 30-60 min/day of continuous aerobic exercise.
In order to accurately check the daily exercise amount, the exercise amount was adjusted to about 3000 by a pedometer, and no drugs that affect the blood viscosity were used to monitor only the effect of the exercise. The aerobic exercise was continued for 2 weeks at a given time, and the clinical symptoms of the patient improved over time. Two weeks later, the F/U test was confirmed as follows.
Fig.2
[Conclusion]
The above results suggest that the reason patient's clinical symptoms were improved is the vascular supply was improved before and after the exercise, and a greater exercise amount on the right leg than the left would have had a positive influence. The reason that improved SBP difference in lower extremity might be just increase in the exercise volume, so we can think of the increased metabolites due to contracting muscle diffuse to resistance arterioles and act directly to induce vasodilation, and prolonged exercise induces angiogenesis and increases peripheral blood volume. Although the recommended mode, frequency, duration, and intensity of exercise are variable for patient’s profile, it seems reasonable to recommend exercise as part of initial treatment strategy for individuals with peripheral vascular disease. |
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Forty-three-year-old male patient was diagnosed with Klippel-Trénaunay syndrome : port-wine stain, unilateral soft and skeletal tissue hypertrophy and unusal varicosities
A) before exercise. B) after exercise : Endurance exercise training with unilateral weight lifting elicits an average reduction of 28 mm Hg for difference of ankle SBP and average elevation of 0.5 °C for surface temperatue of right lower extremity.
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