Hot Water Therapy Aids Patients With Peripheral Arterial Disease

Heat therapy can improve functional ability and also has potential to be an effective cardiovascular conditioning tool for people with peripheral arterial disease (PAD), according to a small study published online June 5 in the American Journal of Physiology-Heart and Circulatory Physiology.

Ashley P. Akerman, from the University of Otago in New Zealand, and colleagues randomly assigned patients with PAD to either 12 weeks of heat (11 patients; mean age, 76 years; four women) or exercise (11 patients; mean age 74 years; three women). The heat intervention involved spa bathing at 39 degrees C for three to five days per week for ≤30 minutes, followed by ≤30 minutes of calisthenics. The exercise intervention involved ≤90 minutes of supervised walking and gym-based exercise one to two days per week.

The researchers found that after 12 weeks, total walking distance during a six-minute walk test increased and pain-free walking distance increased in both groups. Following heat, systolic blood pressure declined more than following exercise (−7 mm Hg [95 percent confidence interval, −4 to −10; P < 0.001] and −3 mm Hg [95 percent confidence interval, 0 to −6; P = 0.078], respectively). In both groups, diastolic and mean arterial pressure decreased by 4 mm Hg. There were no significant changes in blood volume, ankle-brachial index, or measures of vascular health. There were also no differences in improvement in functional or blood pressure outcomes between the groups. Heat therapy had excellent adherence and was well tolerated.

"Further studies to confirm the clinical benefits of heat therapy will be required along with the refinement of systems to provide heat therapy in a safe and efficient way," the authors write.

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