Supervised Cycling Training Improves Erythrocyte Rheology in Individuals With Peripheral Arterial Disease

Chih Chin Hsu, Yu Ting Lin, Tieh-Cheng Fu, Shu Chun Huang, Cheng Hsien Lin, Jong Shyan Wang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review


Peripheral arterial disease (PAD) results in insufficient flow to lower extremities. Aerobic exercise provides health benefits for individuals with PAD, but basic science behind it is still debated. Twenty-one PAD patients aged about 70 years with female/male as 7/14 were recruited. Among them, 11 were randomized to have supervised cycling training (SCT) and 10 to receive general healthcare (GHC) as controls. SCT participants completed 36 sessions of SCT at the first ventilation threshold within 12 weeks and the controls received GHC for 12 weeks. Ankle-brachial index (ABI), 6-min walk test (6MWT), peak oxygen consumption ((Formula presented.) O2peak), minute ventilation ((Formula presented.) E), minute carbon dioxide production ((Formula presented.) CO2), erythrocyte rheology, including the maximal elongation index (EImax) and shear stress at 50% of maximal elongation (SS1/2), and the Short Form-36 (SF-36) questionnaire for quality of life (QoL) were assessed before and 12 weeks after initial visit. SCT significantly decreased the SS1/2 as well as SS1/2 to EImax ratio (SS1/2/EImax) and increased the erythrocyte osmolality in the hypertonic region as well as the area under EI-osmolality curve. The supervised exercise-induced improvement of erythrocyte deformability could contribute to the increased peripheral tissue O2 delivery and was possibly related with increased (Formula presented.) O2peak. The physiological benefit was associated with significantly increased ABI, 6-min walking distance, cardiorespiratory fitness, and SF-36 score. However, no significant changes in aerobic capacity and erythrocyte rheological properties were observed after 12-week of GHC. In conclusion, SCT improves aerobic capacity by enhancing erythrocyte membrane deformability and consequently promotes QoL in PAD patients.

Original languageEnglish
Article number792398
JournalFrontiers in Physiology
StatePublished - 05 01 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 Hsu, Lin, Fu, Huang, Lin and Wang.


  • aerobic exercise
  • erythrocyte deformability
  • erythrocyte osmotic fragility
  • hemorheology
  • peripheral arterial disease


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