Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with attenuated vascular function, cardiorespiratory capacity, physical function, and muscular strength. It is essential to combat these negative effects on health by incorporating lifestyle interventions to slow disease progression, such as exercise. We sought to examine the effects of aquatic walking exercise on cardiovascular function, cardiorespiratory capacity (VO2max), exercise tolerance (6-minute walking distance, 6MWD), physical function, muscular strength, and body composition in patients with PAD. Patients with PAD (n=72) were recruited and randomly assigned to a 12-week aquatic walking training group (AQ, n=35) or control (CON, n=37). The AQ group performed walking and leg exercises in waist-to-chest deep water. Leg arterial stiffness (femoral-to-ankle pulse-wave velocity, legPWV), heart rate (HR), blood pressure (BP), ankle-to-brachial index (ABI), VO2max, 6MWD, physical function, muscular strength, body composition, resting metabolic rate (RMR), and flexibility were measured before and after 12 weeks. There were significant group by time interactions (p<0.05) after 12 weeks for legPWV and HR, which significantly decreased (p<0.05), and VO2max, 6MWD, physical function, and muscular strength, which significantly increased (p<0.05) in AQ compared to no changes in CON. There were no significant differences (p>0.05) for BP, ABI, RMR, or flexibility after 12 weeks. Interestingly, there was relatively high adherence (84%) to the aquatic walking exercise program in this population. These results suggest that aquatic walking exercise is an effective therapy to reduce arterial stiffness and resting HR, and improve cardiorespiratory capacity, exercise tolerance, physical function, and muscular strength in patients with PAD.

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