The goal of this observational study or clinical trial is to investigate how exercise can affect different areas of a person's life, especially those people with vascular disease. This is important because exercise can be beneficial for people with vascular disease. The study could include any of the following: those aged 65 years of age and older, between the ages of 50-64 who smokes, has diabetes, high blood pressure, high cholesterol, or has a family member with vascular disease, between the ages of 18-49 with diabetes and one other factor listed above, or those with vascular disease. The main question\[s\] it aims to answer is if exercise testing can better predict vascular disease.
The following research questions will be addressed in this study:
1. Does baseline ABI influence the magnitude and recovery trajectory of ABI following an acute bout of exercise across a spectrum of vascular function? 2. What association does exercise-induced ABI changes have on patient-reported outcomes of quality of life and intermittent claudication? 3. Do functional outcomes of gait speed, time to claudication, gait variables related to rest breaks in 6MWT, and walking distance predict the magnitude of exercise-induced ABI reduction?
Participants will :
* complete various questionnaires and a routine screening for vascular disease \*walk for 6 minutes at your own pace * additional vascular screening tests will be performed.
individuals over 65 years of age
individuals aged 50-64 with a risk factor for atherosclerosis including diabetes mellitus, history of smoking, hyperlipidemia, hypertension, or family history of peripheral arterial disease (PAD)
individuals aged 18-50 with diabetes mellitus and one additional risk factor for atherosclerosis as noted above, or
individuals with known atherosclerotic disease in another vascular bed including the coronary, carotid, subclavian, renal, or mesenteric artery stenosis, and individuals with known PAD
contraindications to brachial and/or ankle pressure measurement including history of deep vein thrombosis
lymphedema of the arms or legs
history of mastectomy or current leg ulceration preventing placement of a blood pressure cuff around the lower leg
an inability to lie in a supine position for 15 min
recruited from local outpatient rehabilitation, vascular, and internal medicine clinics
Cohort
Prospective
Not listed
magnitude of ABI reduction
Measured as both absolute and percent change, calculated as the difference between baseline ABI and ABI immediately after exercise, at 1-, 3-, and 5-minute recovery intervals.
Short-Form 36 (SF-36)
A generic outcome survey to quantify health status and health-related quality of life over 8 health domains. Minimum possible score is 0 and maximum possible score is 100. A higher score indicates better health condition, complete functioning, or absence of limitations.
International Physical Activity Questionnaire (IPAQ)
The IPAQ classifies individuals into low/moderate/high activity levels based on their subjective report of frequency, duration, and intensity of walking, moderate, and vigorous activity. Scoring for the IPAQ places individuals into a level based on their categorical score: Low Those who not meet criteria for categories 2 or 3 are considered low/inactive. Moderate Any one of the following three criteria: * 3 or more days of vigorous activity of at least 20 minutes per day OR * 5 or more days of moderate-intensity activity or walking of at least 30 min per day OR * 5 or more days of any combination of walking, moderate-intensity or vigorous intensity activities achieving a minimum of at least 600 MET-min/week. High Any one of the following two criteria: * Vigorous-intensity activity on at least 3 days and accumulate at least 1500 MET-min/week OR * 7 or more days of any combo of walking, moderate-intensity or vigorous intensity activities achieving a minimum of at least 3000 MET-min/week
Gait speed
Gait speed is measured as the time taken to walk a fixed distance of 4-meters measured in meters per second (m/s) taken at a set time during the 6MWT.
Time to first standing rest break
The time until the participant takes their first standing rest break during the 6MWT, measured in seconds (s)
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