To Indicate The Long-Term Endurance Exercises on Vena Saphena Magna and Peripheric Venous Circulation, Exercise Capacity, and Quality of Life

Serap Acar; Öykü Bulduk; İsmail Nafi Özdamar; Merve Yüksel; Belgin Güleryüz; Mustafa Mahmut Barış; Tuğra Gençpınar

To Indicate The Long-Term Endurance Exercises on Vena Saphena Magna and Peripheric Venous Circulation, Exercise Capacity, and Quality of Life

Abstract

Objectives: The aim of this study was to compare the exercise capacity, quality of life and Vena Saphena Magna and peripheric venouse circulation on endurance exercises in individuals with peripheric vessel failure. Methods: Sixteen patients aged between 35 and 65 years, who had Peripheral Arterial Disease and were being followed up with compression stockings only, participated in an eight-week moderate-intensity endurance exercise program consisting of 150 minutes per week. Pain levels were assessed with the Visual Analog Scale (VAS), quality of life was evaluated with the Short Form-12 (SF-12), and exercise capacity was measured with the Six-Minute Walk Test (6MWT) before and after the exercise training. Inaddition, the diameter of the great saphenous vein (Vena Saphena Magna,VSM) was measured for each participant with Doppler Ultrasonography. A total of 14 patients completed the study, and all participants demonstrated a significant improvement in exercise capacity (p < 0.05), along with favorable improvements in venous vessel diameter (p < 0.05). Results: The intervention was observed to improve walk distance and walk ability, as well as fatigue and pain variables, in adults with Peripheral Arterial Disease. Inaddition, according to Doppler ultrasonography data, significant results were obtained regarding the increase in peripheral vessel diameters. Conclusion: Long-term endurance exercises were found to increase exercise capacity and resulted in significant improvements in venous vessel diameters. However, further researches should indicated to determine the detailed outcomes and to investigate the intervention components which may support other functional outcomes.

Keywords

Supporting Institution

The Scientific and Technological Research Council of Türkiye

Ethical Statement

Dokuz Eylül University Ethical Comittee approved the study.

Thanks

In view of expertise of the The Scientific and Technological Research Council of Türkiye this research protocol has been studied PT Öykü BULDUK

References

Haas TL, Lloyd PG, Yang HT, Terjung RL. Exercise training and peripheral arterial disease. Compr Physiol. 2012 Oct;2(4):2933-3017.
Song P, Rudan D, Zhu Y, Fowkes FJI, Rahimi K, Fowkes FGR, Rudan I. Global, regional, andnationalprevalenceand risk factorsforperipheralarterydisease in 2015: an updatedsystematicreviewandanalysis. LancetGlobHealth. 2019 Aug;7(8):e1020-e1030.
Mitchell RG, Duscha BD, Robbins JL, Redfern SI, Chung J, Bensimhon DR, Kraus WE, Hiatt WR, Regensteiner JG, Annex BH. Increasedlevels of apoptosis in gastrocnemiusskeletalmuscle in patientswithperipheralarterialdisease. VascMed. 2007 Nov;12(4):285-90.
Coca-Martinez M, Girsowicz E, Doonan RJ, Obrand DI, Bayne JP, Steinmetz OK, Mackenzie KS, Carli F, Martinez-Palli G, Gill HL. MultimodalPrehabilitationforPeripheralArterialDiseasePatientswithIntermittentClaudication-A Pilot RandomizedControlled Trial. AnnVascSurg. 2024 Oct;107:2-12.
Hallak AO, Hallak FZ, Hallak YO, Hallak OO, Hayson AW, Tanami SA, Bennett WL, Lavie CJ. ExerciseTherapy in the Management of PeripheralArterialDisease. Mayo ClinProcInnovQualOutcomes. 2023 Oct 3;7(5):476-489.
Thangada ND, McDermott MM. ExerciseTherapyforPeripheralArteryDisease. CurrCardiolRep. 2024 May;26(5):405-412.
Gardner AW, Parker DE, Montgomery PS, Blevins SM. Step-monitored home exercise improves ambulation, vascular function, and inflammation in symptomatic patients with peripheral artery disease: a randomized controlled trial. J Am Heart Assoc. 2014 Sep 18;3(5):e001107.
Crowther RG, Spinks WL, Leicht AS, Sangla K, Quigley F, Golledge J. Effects of a long-termexercise program on lowerlimbmobility, physiologicalresponses, walkingperformance, andphysicalactivitylevels in patientswithperipheralarterialdisease. J VascSurg. 2008 Feb;47(2):303-9.

Julious, Steven A. "Sample size of 12 per group rule of thumb for a pilot study." Pharmaceutical Statistics: The Journal of Applied Statistics in the Pharmaceutical Industry 4.4 (2005): 287-291.
Gardner AW, Poehlman ET. Exerciserehabilitationprogramsforthetreatment of claudicationpain. A meta-analysis. JAMA. 1995 Sep 27;274(12):975-80.
Gardner AW, Montgomery PS, Parker DE. Optimal exercise program lengthforpatientswithclaudication. J VascSurg. 2012 May;55(5):1346-54.
Mazzolai L, Belch J, Venermo M, Aboyans V, Brodmann M, Bura-Rivière A, Debus S, Espinola-Klein C, Harwood AE, Hawley JA, Lanzi S, Madarič J, Mahé G, Malatesta D, Schlager O, Schmidt-Trucksäss A, Seenan C, Sillesen H, Tew GA, Visonà A. Exercise Therapy for Chronic Symptomatic Peripheral Artery Disease: A Clinical Consensus Document of the European Society of Cardiology Working Group on Aorta and Peripheral Vascular Diseases in Collaboration With the European Society of Vascular Medicine and the European Society for Vascular Surgery. Eur J Vasc Endovasc Surg. 2024 Feb 16:S1078-5884(24)00011-X.
Fassora M, Calanca L, Jaques C, Mazzolai L, Kayser B, Lanzi S. Intensity-dependent effects of exercise therapy on walking performance and aerobic fitness in symptomatic patients with lower-extremity peripheral artery disease: A systematic review and meta-analysis. Vasc Med. 2022 Apr;27(2):158-170.
Toosizadeh N, Stocker H, Thiede R, Mohler J, Mills JL, Najafi B. Alterations in gait parameters with peripheral artery disease: The importance of pre-frailty as a confounding variable. Vasc Med. 2016 Dec;21(6):520-527.
Akbay A, Visual Analog Skala (VAS) Değerlendirmesi, Türk Nöroşirurji Derneği, Spinal ve Periferik Sinir Cerrahisi Grubu.
Poku E, Duncan R, Keetharuth A, Essat M, Phillips P, Woods HB, Palfreyman S, Jones G, Kaltenthaler E, Michaels J. Patient-reported outcome measures in patients with peripheral arterial disease: a systematic review of psychometric properties. Health Qual Life Outcomes. 2016 Nov 24;14(1):161.
Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form HealthSurvey: construction of scalesandpreliminarytests of reliabilityandvalidity. MedCare. 1996 Mar;34(3):220-33.
Soylu C. ve Kütük B., SF-12 Yaşam Kalitesi Ölçeği’nin Türkçe Formunun Güvenirlik ve Geçerlik Çalışması, Türk Psikiyatri Dergisi, 2022;33(2):108-117.
McDermott MM, Guralnik JM, Criqui MH, Liu K, Kibbe MR, Ferrucci L. Six-minute walk is a better outcome measure than treadmill walking tests in therapeutic trials of patients with peripheral artery disease. Circulation. 2014 Jul 1;130(1):61-8.
Polat İ, 6 Dakika Yürüme Testi Mesafesinin Koşullama ile Değişiminin Değerlendirilmesi, T.C. Fırat Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, 2019; 27-29.
Scherr J, Wolfarth B, Christle JW, Pressler A, Wagenpfeil S, Halle M. Associations between Borg's rating of perceived exertion and physiological measures of exercise intensity. Eur J Appl Physiol. 2013 Jan;113(1):147-55.
Borg GA. Psychophysicalbases of perceivedexertion. MedSci Sports Exerc. 1982;14(5):377-81.
Savcı S, Öztürk M, Arıkan H, İnce D. İ. ve Tokgözoğlu L, Physicalactivitylevels of universitystudents, Türk Kardiyoloji Derneği Araştırması, 2006; 34(3): 166-172.
Clina JG, Sayer RD, Friedman JE, Chui TK, Mehta T, Rimmer JH, Hill JO. Reliability and Validity of the International Physical Activity Questionnaire Adapted to Include Adults With Physical Disability. J Phys Act Health. 2023 Dec 6;21(2):189-196.
Sarshar, S. ., Khan, MB ., Muhammad, D. ., Sanaullah, ., Parveen, I. ., & Sarfaraz, S. . (2025). CTA'yı Altın Standart Olarak Kullanarak Alt Ekstremite Periferik Arter Hastalığının Doppler USG Değerlendirmesinin Doğruluğu. Biyolojik ve Klinik Bilimler Araştırma Dergisi, 6 (5), 152–155.
Guirro ECO, Leite GPMF, Dibai-Filho AV, Borges NCS, Guirro RRJ. Intra- and Inter-rater Reliability of Peripheral Arterial Blood Flow Velocity by Means of Doppler Ultrasound. J Manipulative Physiol Ther. 2017 May;40(4):236-240.
Adler C, Mousa A, Rhee A, Patel MD. Varicose Veins of the Lower Extremity: Doppler US Evaluation Protocols, Patterns, and Pitfalls. Radiographics. 2022 Nov-Dec;42(7):2184-2200. doi: 10.1148/rg.220057. Epub 2022 Sep 30. PMID: 36178804.
Heizmann AN, Ollier E, Labeix P, Goujon I, Roche F, Le Hello C. Step Count Accuracy of the Life Plus Connected Watch at Different Localizations and Speeds in Healthy Adults, Patients With Cardiovascular Disease, and Patients With Peripheral Artery Disease: Step Count Validation Study in Laboratory Settings. JMIR Form Res. 2025 Feb 10;9:e58964.
Kohrt WM, Malley MT, Coggan AR, Spina RJ, Ogawa T, Ehsani AA, Bourey RE, Martin WH 3rd, Holloszy JO. Effects of gender, age, andfitnesslevel on response of VO2max totraining in 60-71 yrolds. J ApplPhysiol (1985). 1991 Nov;71(5):2004-11.
Uçan İ, 6 Haftalik Aerobik Egzersizin Sedanter Bireylerin Vücut Kompozisyonu Üzerine Etkileri, Kilis 7 Aralık Üniversitesi Beden Eğitimi ve Spor Bilimleri Dergisi, 2018; 2(2): 2-8.
Silva I., Moreira C. S., Pedras S., Oliveria R., Veiga C., Moreira L. et.al. Effect of a monitoredhome-basedexercise program combinedwith a behaviorchangeinterventionand a smartphoneapp on walkingdistancesandquality of life in adultswithperipheralarterialdisease: theWalkingPadrandomizedclinicaltrial, Frontiers in Cardiovascular Medicine, 2023, 22:10:1272897.
Lane R., Harwood A., Watson L. andLeng G. C., Exerciseforintermittentclaudication, Cochrane Database of SystematicReviews,2017;12(12).
Padberg FT Jr, Johnston MV, Sisto SA. Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial. J Vasc Surg. 2004 Jan;39(1):79-87.
Silva KLS, Figueiredo EAB, Lopes CP, Vianna MVA, Lima VP, Figueiredo PHS, Costa HS. The impact of exercise training on calf pump function, muscle strength, ankle range of motion, and health-related quality of life in patients with chronic venous insufficiency at different stages of severity: a systematic review. J Vasc Bras. 2021 Apr 28;20:e20200125.
Mosti G, Partsch H. Improvement of venous pumping function by double progressive compression stockings: higher pressure over the calf is more important than a graduated pressure profile. Eur J Vasc Endovasc Surg. 2014 May;47(5):545-9.
Gardner AW, Parker DE, Montgomery PS, Scott KJ, Blevins SM. Efficacy of quantified home-based exercise and supervised exercise in patients with intermittent claudication: a randomized controlled trial. Circulation. 2011 Feb 8;123(5):491-8. doi: 10.1161/CIRCULATIONAHA.110.963066. Epub 2011 Jan 24. PMID: 21262997; PMCID: PMC3154843.
McDermott MM, Liu K, Guralnik JM, Criqui MH, Spring B, Tian L, Domanchuk K, Ferrucci L, Lloyd-Jones D, Kibbe M, Tao H, Zhao L, Liao Y, Rejeski WJ. Home-based walking exercise intervention in peripheral artery disease: a randomized clinical trial. JAMA. 2013 Jul 3;310(1):57-65. doi: 10.1001/jama.2013.7231. PMID: 23821089; PMCID: PMC6007977.
Fokkenrood HJ, Lauret GJ, Verhofstad N, Bendermacher BL, Scheltinga MR, Teijink JA. The effect of supervised exercise therapy on physical activity and ambulatory activities in patients with intermittent claudication. Eur J Vasc Endovasc Surg. 2015 Feb;49(2):184-91. doi: 10.1016/j.ejvs.2014.11.002. Epub 2014 Dec 12. PMID: 25496986.
Chandrashekar A, Gasparis A, Labropoulos N. Lack of symmetry in the major lower limb veins. J Vasc Surg Venous Lymphat Disord. 2017 May;5(3):346-352. doi: 10.1016/j.jvsv.2016.11.010. Epub 2017 Feb 8. PMID: 28411701.

Details

Primary Language

English

Subjects

Physiotherapy

Journal Section

Research Article

Authors

Serap Acar ^*
0000-0001-8226-1543
Türkiye

Öykü Bulduk
0009-0005-3884-1053
Türkiye

İsmail Nafi Özdamar
0009-0004-7014-8892
Türkiye

Merve Yüksel This is me
0009-0007-7558-9103
Türkiye

Belgin Güleryüz This is me
0009-0007-5963-5624
Türkiye

Mustafa Mahmut Barış
Türkiye

Tuğra Gençpınar
0000-0003-4438-7991
Türkiye

Publication Date

June 30, 2026

Submission Date

November 26, 2025

Acceptance Date

May 17, 2026

Published in Issue

Year 2026 Volume: 2 Number: 1

IZ

https://izlik.org/JA38JR38KX

Cite

RIS / Bibtex

APA

Acar, S., Bulduk, Ö., Özdamar, İ. N., Yüksel, M., Güleryüz, B., Barış, M. M., & Gençpınar, T. (2026). To Indicate The Long-Term Endurance Exercises on Vena Saphena Magna and Peripheric Venous Circulation, Exercise Capacity, and Quality of Life. Clinical Physiotherapy and Related Research, 2(1), 1-15. https://izlik.org/JA38JR38KX

AMA

1.Acar S, Bulduk Ö, Özdamar İN, et al. To Indicate The Long-Term Endurance Exercises on Vena Saphena Magna and Peripheric Venous Circulation, Exercise Capacity, and Quality of Life. Clinical Physiotherapy and Related Research. 2026;2(1):1-15. https://izlik.org/JA38JR38KX

Chicago

Acar, Serap, Öykü Bulduk, İsmail Nafi Özdamar, et al. 2026. “To Indicate The Long-Term Endurance Exercises on Vena Saphena Magna and Peripheric Venous Circulation, Exercise Capacity, and Quality of Life”. Clinical Physiotherapy and Related Research 2 (1): 1-15. https://izlik.org/JA38JR38KX.

EndNote

Acar S, Bulduk Ö, Özdamar İN, Yüksel M, Güleryüz B, Barış MM, Gençpınar T (June 1, 2026) To Indicate The Long-Term Endurance Exercises on Vena Saphena Magna and Peripheric Venous Circulation, Exercise Capacity, and Quality of Life. Clinical Physiotherapy and Related Research 2 1 1–15.

IEEE

[1]S. Acar et al., “To Indicate The Long-Term Endurance Exercises on Vena Saphena Magna and Peripheric Venous Circulation, Exercise Capacity, and Quality of Life”, Clinical Physiotherapy and Related Research, vol. 2, no. 1, pp. 1–15, June 2026, [Online]. Available: https://izlik.org/JA38JR38KX

ISNAD

Acar, Serap - Bulduk, Öykü - Özdamar, İsmail Nafi - Yüksel, Merve - Güleryüz, Belgin - Barış, Mustafa Mahmut - Gençpınar, Tuğra. “To Indicate The Long-Term Endurance Exercises on Vena Saphena Magna and Peripheric Venous Circulation, Exercise Capacity, and Quality of Life”. Clinical Physiotherapy and Related Research 2/1 (June 1, 2026): 1-15. https://izlik.org/JA38JR38KX.

JAMA

1.Acar S, Bulduk Ö, Özdamar İN, Yüksel M, Güleryüz B, Barış MM, Gençpınar T. To Indicate The Long-Term Endurance Exercises on Vena Saphena Magna and Peripheric Venous Circulation, Exercise Capacity, and Quality of Life. Clinical Physiotherapy and Related Research. 2026;2:1–15.

MLA

Acar, Serap, et al. “To Indicate The Long-Term Endurance Exercises on Vena Saphena Magna and Peripheric Venous Circulation, Exercise Capacity, and Quality of Life”. Clinical Physiotherapy and Related Research, vol. 2, no. 1, June 2026, pp. 1-15, https://izlik.org/JA38JR38KX.

Vancouver

1.Serap Acar, Öykü Bulduk, İsmail Nafi Özdamar, Merve Yüksel, Belgin Güleryüz, Mustafa Mahmut Barış, Tuğra Gençpınar. To Indicate The Long-Term Endurance Exercises on Vena Saphena Magna and Peripheric Venous Circulation, Exercise Capacity, and Quality of Life. Clinical Physiotherapy and Related Research [Internet]. 2026 Jun. 1;2(1):1-15. Available from: https://izlik.org/JA38JR38KX