Practical Guide about PAD

↪ Canadian Foundation for Vascular Health 20 The tools We have seen previously that exercise is more effective when the training session is more intense. That is why the clinical practice guidelines indicate a preference for training supervised by an exercise specialist versus exercising alone at home 3 . On the other hand, the improvements made alone with your own resources can also be extraordinary 4 . Here are some pro tips for maximizing your results. 8.1. Stationary machines The use of stationary machines means you can control several parameters, such as resistance and speed, and not depend on unpredictable temperatures or terrain. The choice of stationary machine will depend on your budget, available space at home and disease stage. 8.1.1. Treadmill A treadmill is the preferred machine for optimizing walking distance. It indicates distance and time, so is effective for noticing your progress. The clear advantage of this machine is that you can choose the speed and slope on a smooth surface with grab bars to prevent falls and a belt with slight impact absorption for fragile joints. To start a session on a treadmill, it is suggested that you start with a low speed that causes no pain. You should try walking for a few minutes or seconds at that speed to gradually increase blood flow to the legs. When pain starts, you should take a 1- or 2-minute break to reduce the pain or make it disappear. Then, you should start walking again and gradually increase until pain occurs, then continue with that discomfort until the mechanics of walking become difficult. You should record the speed at which pain occurs and see whether the speed rises as you exercise regularly. If simply increasing the speed no longer produces discomfort, you should gradually increase the slope 2 . Keep a small notebook so you can record the machine parameters (e.g., speed, slope, etc.) and what you feel. You will then be able to discuss them with your kinesiologist or healthcare professional. 8.1.2. Stationary bike If just walking a few steps causes sharp pain, a stationary bike may be an interesting alternative and is a less expensive machine than a treadmill. When you sit on the bike, your legs no longer carry your body weight. This makes effort easier. Some people have pain in their legs when walking, but not on a bike. So, that may be a more pleasant way of obtaining very beneficial results. You can spend the first few minutes of an exercise session on the bike, before walking on a treadmill or on the ground. This makes it easier to start walking, since the previous warm-up on the bike has caused the blood vessels to open up, making it easier to walk 5 . 8.1.3. Arm exercise bike If walking is too painful and a bike is too bulky, an arm exercise bike may be an interesting option. These exercise bikes are now available in many big-box stores or pharmacies. These small exercise bikes can be placed on a table to turn with your arms. Please note that these exercise bikes can also be placed on the floor in front of a chair to pedal with your legs. Pedaling with your arms rarely causes the leg muscle pain that can be felt when walking. However, this type of exercise increases the work of the heart, pumping blood all around the body. Providing additional blood to the blood vessels gives nutrients and oxygen to the muscles throughout the body, even muscles which are not working. In this way, making the arms work can produce improvement in breath and walking distance 6 . If you have chest pain while doing this type of exercise, see a doctor right away. Similarly, do not place the exercise bike too high up on a table, so as not to overload the shoulders. The central axis should be aligned with your eyes. 8.1.4. Additional machines Elliptical or step machines are also excellent ways of improving symptoms. However, minimum intensity on these machines is often great and even very short sessions can cause pain, which may be less beneficial. Thesemachines are preferential for individuals at amore advanced level or a less severe stage of the disease.