Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 02 Jun 2025

Active Warm-Up and 6-Min Walk Test in Patients with Peripheral Arterial Disease

PhD, ACSM-CEP,
MS, ACSM-CEP,
BS, ACSM-CEP,
PhD, FACSM, and
PhD, FACSM
Page Range: 30 – 35
DOI: 10.31189/2165-6193-14.2.30
Save
Download PDF

ABSTRACT

Background

Peripheral arterial disease (PAD) leads to an accelerated decline in functional capacity and disability, and patients with PAD have a high risk of morbidity and mortality. At least one study has shown that passive lower-limb heating improves 6-min walk test (6MWT) distance in patients with PAD. It is unknown whether an active walking warm-up can also increase 6MWT distance, and ultimately training performance, in patients with PAD. The purpose of this study was to quantify the effect of an active walking warm-up on the results of the 6MWT in patients with PAD.

Methods

In a block-randomized crossover design, 16 patients with PAD (10 men, 6 women, ages 69 to 85 y, resting ankle-brachial index 0.68 ± 0.15) completed two 6MWTs separated by 2 to 3 d. One 6MWT was preceded by an active warm-up of 10 to 12 min of walking on a treadmill (WARM-UP) at a workload between 1.4 and 2.1 metabolic equivalents (METs) and the other 6MWT was completed without a warm-up (NO WARM-UP). Outcome measures were total distance walked, distance to claudication onset, and time to claudication onset.

Results

Total walking distance did not differ between conditions (WARM-UP 297 ± 17 m vs NO WARM-UP 304 ± 16 m, mean ± 95% confidence interval, P = 0.358). Claudication onset distance did not differ between conditions (WARM-UP 142 ± 24 m vs NO WARM-UP 120 ± 16 m, P = .188). Claudication onset time did not differ between conditions (WARM-UP 154 ± 19 seconds vs NO WARM-UP 137 ± 16 seconds, P = 0.272).

Conclusion

An active warm-up of 10-12 min on a treadmill at 1.4-2.1 METs may not be enough of a stimulus to increase 6MWT distance in patients with PAD.

Keywords: exercise; rehabilitation; claudication; ambulation
Copyright: Copyright © 2025 Clinical Exercise Physiology Association
FIGURE 1.
FIGURE 1.

Study protocol.

FIGURE 2.
FIGURE 2.

The effect of an active warm-up on the 6-min walk test total distance with WARM-UP (297 ± 17 m) and NO WARM-UP (304 ± 16 m) conditions in patients with peripheral arterial disease; n = 16 (10 men, 6 women); P value is a paired t test between conditions.

FIGURE 3.
FIGURE 3.

The effect of an active warm-up on the 6-min walk test claudication onset distance with WARM-UP (142 ± 24 m) and NO WARM-UP (120 ± 16 m) conditions in patients with peripheral arterial disease; n = 16 (10 men, 6 women); P value is a paired t test between conditions.

FIGURE 4.
FIGURE 4.

The effect of an active warm-up on the 6-min walk test claudication onset time with WARM-UP (154 ± 19 seconds) and NO WARM-UP (137 ± 16 seconds) conditions in patients with peripheral arterial disease; n = 16 (10 men, 6 women); P value is a paired t test between conditions.

Contributor Notes

Address for correspondence: Aaron W. Harding, PhD, Cardiovascular Wellness & Rehabilitation, PeaceHealth, 3311 RiverBend Drive, Springfield, OR 97477; (541) 222-7216; e-mail: aharding@peacehealth.org.

Conflicts of Interest and Source of Funding: This research was supported by NIH R01HL144128 and R01AG072805. No conflicts of interest.

  • Download PDF