Short-duration aerobic high-intensity intervals versus moderate exercise training intensity in patients with peripheral artery disease: study protocol for a randomised controlled trial (the Angiof-HIIT Study).

Supervised exercise training is among the first-line therapies for patients with peripheral artery disease (PAD). Current recommendations for exercise include guidance focusing on claudication pain, programme and session duration, and frequency. However, no guidance is offered regarding exercise training intensity. This study aims to compare the effects of 12-week-long supervised walking exercise training (high-intensity interval training (HIIT) vs moderate-intensity exercise (MOD)) in patients with chronic symptomatic PAD. This study is a monocentric, interventional, non-blinded randomised controlled trial. 60 patients (30 in each group) will be randomly allocated (by using the random permuted blocks) to 12 weeks (three times a week) of HIIT or MOD. For HIIT, exercise sessions will consist of alternating brief high-intensity (≥85% of the peak heart rate (HR <sub>peak</sub> )) periods (≤60 s) of work with periods of passive rest. Patients will be asked to complete 1 and then 2 sets of 5-7 (progressing to 10-15×60 s) walking intervals. For the MOD group, exercise training sessions will consist of an alternation of periods of work performed at moderate intensity (≤76% HR <sub>peak</sub> ) and periods of passive rest. Interventions will be matched by training load. The primary outcome will be the maximal walking distance. Secondary outcomes will include functional performance, functional capacity, heath-related quality of life, self-perceived walking abilities, physical activity and haemodynamic parameters. The Angiof-HIIT Study was approved by the Human Research Ethics Committee of the Canton de Vaud (study number: 2022-01752). Written consent is mandatory prior to enrolment and randomisation. The results will be disseminated via national and international scientific meetings, scientific peer-reviewed journals and social media. NCT05612945

Sit-to-stand muscle power is related to functional performance at baseline and after supervised exercise training in patients with lower extremity peripheral artery disease.

Patients with peripheral artery disease (PAD) have decreased muscle power contributing to functional limitations. The sit-to-stand (STS) is a validated test to assess muscle power in older individuals; however, it has never been investigated in patients with PAD. We evaluated the relationship between STS muscle power and common disease-related outcomes at baseline and following supervised exercise training (SET) in patients with PAD. This observational study investigated patients with Fontaine stage II. Before and after SET, maximal treadmill walking distance (MWD), functional performance tests (six-min walk, STS, stair climbing, habitual gait speed) and quality of life (SF-36 questionnaire) were assessed. Relative (W <sup>.</sup> kg <sup>-1</sup> ) STS muscle power was calculated using a validated equation. Multiple regressions models were used. Ninety-five patients with PAD were included (63.1±12.1 years, 67% male). Relative STS muscle power [before: 2.7 W <sup>.</sup> kg <sup>-1</sup> (95%CI 2.5-2.9); after: 3.3 (95%CI 3.1-3.6)], MWD [before: 367.0 m (95%IC 302.4-431.5); after: 598.4 (95%IC 515.6-681.3)], six-min walking distance [before: 418.3 m (95%IC 399.4-437.2); after: 468.8 (95%IC 452.7-484.9)], stair climbing performance [before: 6.8 s (95%IC 6.2-7.4); after: 5.3 (95%IC 4.9-5.7)], habitual gait speed [before: 1.10 m <sup>.</sup> s <sup>-1</sup> (95%IC 1.05-1.14); after: 1.18 (95%IC 1.14-1.22)] significantly increased following SET (P≤.001). Similarly, physical [before: 31.4 (95%IC 29.4-33.3); after: 35.8 (95%IC 33.9-37.7)] and mental [before: 39.5 (95%IC 37.0-42.0); after: 43.1 (95%IC 40.9-45.4)] component summaries of the SF-36 significantly increased (P≤.001). Greater relative STS muscle power at baseline was significantly related to greater baseline treadmill (β≤.380; P≤.002) and functional (β≤.597; P≤.001) performance, and quality of life (β≤.291; P≤.050). Larger increases in relative STS muscle power following SET were associated with greater improvements in functional performance (β≤.419; P≤.009). STS test is a valid clinical tool to monitor overall functional status in patients with symptomatic PAD