OBJECTIVE Resistance training (RT) improves walking ability in persons with peripheral artery disease. We conducted a meta-analysis of randomised controlled trials (RCTs) investigating the effect of RT on peripheral artery disease (as measured by walking ability). DESIGN We included RCTs that investigated the effect of RT on treadmill and/or 6 min walk (6-MWT) distances. RT intensity was assessed according to the American College of Sports Medicine guidelines by 1 repetition maximum or rating of perceived exertion. Standardised mean (SMD) and mean differences (MD) were calculated using a random-effects inverse variance model. Heterogeneity and bias were assessed using RevMan V.5.3. Meta-regression and meta-analysis of variance were performed as moderator analyses. DATA SOURCES Databases (Medline, Embase, Web of Science, Cinahl and Google Scholar) were searched until July 2018. RESULTS Fifteen trials isolated RT; 7 trials compared RT with aerobic exercise. We analysed 826 patients (n=363 completing RT), with a mean age of 67.1±3.8 years. Training ranged from low-high intensity, 2-7 times per week for 17±7 weeks, with a mix of upper, lower or whole body training. Overall RT significantly improved constant load treadmill claudication onset (COD) (SMD 0.66 [0.40, 0.93], p<0.00001) and total walking distance (WD) (SMD 0.51 [0.23, 0.79], p=0.0003), progressive treadmill COD (SMD 0.56 [0.00, 1.13], p=0.05) and total WD (SMD 0.45 [0.08, 0.83], p=0.02), and 6-MWT COD (MD 82.23 m [40.91, 123.54], p<0.0001). Intensity played a role in improvement, with high-intensity training yielding the greatest improvement (p=0.02). CONCLUSIONS RT clinically improved treadmill and flat ground walking ability in persons with peripheral artery disease. Higher intensity training was associated with better outcomes. Our study makes a case for clinicians to include high-intensity lower body RT in the treatment of peripheral artery disease. TRIAL REGISTRATION NUMBER CRD42017081184.

中文翻译：

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阻力训练作为老年人外周动脉疾病的治疗方法：系统评价和荟萃分析。

目的阻力训练（RT）可以改善周围动脉疾病患者的步行能力。我们进行了一项随机对照试验（RCT）的荟萃分析，研究了RT对周围动脉疾病的影响（通过步行能力来衡量）。设计我们纳入了一些RCT，它们研究了RT对跑步机和/或6分钟步行（6-MWT）距离的影响。根据美国运动医学学院的指南，通过1次重复最大值或感知劳累等级对RT强度进行评估。使用随机效应反方差模型计算标准均值（SMD）和均值差（MD）。使用RevMan V.5.3评估了异质性和偏见。进行荟萃分析和方差的荟萃分析作为主持人分析。数据源数据库（Medline，Embase，Web of Science，Cinahl和Google Scholar）的搜索结果一直持续到2018年7月。7项试验将RT与有氧运动进行了比较。我们分析了826例患者（n = 363完成RT），平均年龄为67.1±3.8岁。训练范围从低强度到高强度，每周2-7次，持续17±7周，并混合了上，下或全身训练。整体RT显着改善了恒定负荷跑步机的lau行开始（COD）（SMD 0.66 [0.40，0.93]，p <0.00001）和总步行距离（WD）（SMD 0.51 [0.23，0.79]，p = 0.0003），渐进式跑步机COD（ SMD 0.56 [0.00，1.13]，p = 0.05）和总WD（SMD 0.45 [0.08，0.83]，p = 0.02）和6-MWT COD（MD 82.23 m [40.91，123.54]，p <0.0001）。强度在改善中发挥了作用，高强度训练产生的改善最大（p = 0.02）。结论RT在临床上改善了外周动脉疾病患者的跑步机和平坦地面行走能力。更高强度的训练与更好的结果相关。我们的研究为临床医生将高强度下体RT纳入外周动脉疾病的治疗提供了依据。试用注册号CRD42017081184。