Effect of Upper Limb Exercises on Intermittent Claudication in Patients with Diabetes: A Randomized Controlled Trial

Background: Intermittent Claudication(IC) is a pain in the lower leg that develops during exercise. This pain is produced by a restriction of blood flow to the leg muscles as a symptom of peripheral arterial disease (PAD) which develops more in patients with type 2 diabetes mellitus (T2DM). Lower limb exercises are more common among physiotherapists than upper limb exercises (ULE), which, according to certain studies, might be a very helpful technique for patients with IC. Objectives: This study aimed to investigate the effect of ULE on IC in patients with T2DM. Methods: Forty T2DM patients with IC, from both sexes, ranging in age from 45 to 55 Years, were recruited from Damanhur Teaching Hospital. They were randomized into two equal groups (n=20). Twenty patients were assigned to the ULE group (group A), which received arm cranking exercise three times per week for three consecutive months plus routine physiotherapy program. Twenty patients were assigned as control group (group B), which received routine physiotherapy program alone three times per week for three consecutive months. The trial evaluatedmaximum walkingdistance (MWD), pain-free walking distance (PFWD), claudication score, ankle/brachial index (ABI) and glycated haemoglobin (HbA1c), before-treatment and after three consecutive months of treatment. Results: The statistical analysis showed that there was a significant increase in MWD and PFWD, while significant decrease in claudication score in favor of group A compared to group B (p < 0.05). However, there was no significant difference in ABI and HBA1c between group A and group B (p > 0.05). Conclusions: Upper limb exercises were an effective therapeutic protocol for reducing IC and associated pain, and improving walking distance in diabetic patients with IC.