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Effects of Three-Week Stair Climbing Exercise for Weight Control: A Case Series Study

Case Report
The Korean Journal of Sports Medicine 2016;34(2):185-189
pISSN 1226-3729 eISSN 2288-6028
제34권 제2호 2016 185
체중조절을 위한 3주간 계단 오르기의 효과
법무부 청주외국인보호소 부속의원1, 서울대학교 의과대학 의학과2, 서울특별시 보라매병원 가정의학과3
Effects of Three-Week Stair Climbing Exercise for Weight Control:
A Case Series Study
Juheon Choi
, Kyungmo Kang
, Jong Seung Kim
, Bumjo O h
Cheongju Immigration Detention Center Clinic, Ministry of Justice, Cheongju,
Department of Medicine, Seoul National University College of Medicine, Seoul,
Department of Family Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
This study is designed to check whether everyday-life stair climbing, which is a low-cost and readily accessible form
of exercise, is effective for reducing overweight of sedentary people in various health indicators. We selected four
overweight people and measured body weight, body fat percentage, muscle quantity, pulmonary function,
lower-extremity strength and volume of thigh muscle and fat. After 3-week exercise of climbing stairs in more than
5 minutes twice a day, same procedures were taken. Body weight was reduced by 3.35 kg on average (standard
deviation [SD], 0.79), and body fat mass by 2.53 kg (SD, 1.36). Lower extremity strength improved about 5%, and
slight loss of thigh fat (right 3.2%; left 13.4%) was observed. However, pulmonary function and muscle quantity did
not grow significantly. Although only four people may not be representative as targets, but it is suggested that stair
climbing has sufficient utility as an easily accessible exercise.
Exercise, Overweight, Sedentary lifestyle, Lower extremity, Pulmonary function tests
Received: July 6, 2016 Revised: October 6, 2016
Accepted: October 13, 2016
Correspondence: Bumjo Oh
Department of Family Medicine, SMG-SNU Boramae Medical
Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea
Tel: +82-2-870-2682, Fax: +82-2-831-0714
Copyright ©2016 The Korean Society of Sports Medicine
This is an Open Access article distributed under the terms of the Creative
Commons Attribution Non-Commercial License (
licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution,
and reproduction in any medium, provided the original work is properly cited.
Obesity is a condition that substantially raises their risk of
morbidity from hypertension, dyslipidemia, type 2 diabetes,
coronary heart disease, etc
. The majority of obese persons who
develop atherosclerotic cardiovascular disease typically have a
clustering of risk factors for metabolic syndrome
. In 2010,
overweight and obesity were estimated to cause 3
4 million deaths
. In Korea, like other developed countries, the number
of obesity population has been gradually increasing, which led
to the prevalence of 31% in adult population (35%
36% in male,
27% in female) since 2007
It is well known that reducing body fat is essential for treating
J Choi, et al. Effects of Three-Week Stair Climbing Exercise for Weight Control: A Case Series Study
186 대한스포츠의학회지
Table 1. Physical characteristics of the subjects
Variable A B C D
Age (yr) 36 37 33 58
Sex Female Male Female Female
PAR-Q - - - -
Height (cm) 154 174 167 149
Weight (kg) 72.3 88.9 73.9 67.0
Body mass index (kg/m
) 30.5 29.4 26.5 30.6
Body fat mass (%) 31.6 26.5 28.6 26.6
Muscle quantity (kg) 22.2 35.2 24.6 21.8
Pulmonary function tests
FVC (L) 3.03 4.94 4.79 3.15
(L) 2.53 3.90 3.99 2.54
Volume of muscle and fat (by CT)
Thigh muscle (Rt, mm
) 11,158.42 16,890.19 9,815.86 10,003.57
Thigh muscle (Lt, mm
) 10,850.97 17,492.72 10,171.19 9,955.67
Thigh fat (Rt, mm
) 13,900.71 10,294.79 12,375.07 8,669.50
Thigh fat (Lt, mm
) 13,857.45 9,450.47 12,737.36 8,774.56
Lower-extremity strength by Biodex
Peak torque (60/sec, Rt, extension) 73.400 197.900 85.100 65.400
Peak torque (60/sec, Rt, flexion) 40.600 77.000 37.900 41.900
Peak torque (60/sec, Lt, extension) 56.200 206.800 51.100 57.400
Peak torque (60/sec, Lt, flexion) 45.300 75.900 19.200 41.500
Peak torque (180/sec, Rt, extension) 52.600 129.700 70.400 50.000
Peak torque (180/sec, Rt, flexion) 19.200 59.000 36.100 29.400
Peak torque (180/sec, Lt, extension) 41.000 139.900 64.200 45.500
Peak torque (180/sec, Lt, flexion) 23.000 52.500 32.700 34.300
PAR-Q: Physical Activity Readiness Questionnaire, FVC: forced vital capacity, FEV
: forced expiratory volume in 1 second,
CT: computed tomography, Rt: right thigh, Lt: left thigh.
obesity, which is achieved by continuous daily diet and exercise.
There have been many studies about the effective ways to exercise
for relieving obesity. Some of them claim that aerobic exercise
such as walking and cycling is proper for obesity, while other
claims strength exercise can help reducing body fat
Stair climbing is a low-cost, inconspicuous, and readily
accessible form of exercise which is associated with a reduced
mortality in populations
. Despite these features, stair climbing
as an exercise modality for resolving or reducing obesity has
not been considered so far, while it is already useful tools for
rehabilitating and enhancing lower limb power
. This study
has been designed to check whether sequent, everyday-life stair
climbing can be effective for the sedentary people in various
health indicators.
Case Report
We selected four overweight people, who volunteered and have
no other underlying condition, and informed consent was obtained
from all of the subjects and the rights of the subjects were protected.
The characteristics of the subjects are shown (Table 1).
We used Physical Activity Readiness Questionnaire to rule
out unsuitable participants. We measured their body weight, body
fat percentage, and muscle quantity via InBody. And we tested
their pulmonary function by PFT, lower-extremity strength by
Isokinetics (De Queen, AR, USA), volume of thigh muscle and
fat by thigh computed tomography (CT). And after the 3-week
exercise of stair climbing in more than 5 minutes twice a day,
same procedures were taken. Participants were supposed to climb
stairs of their apartments and workplaces without rest, and the
interval between climbing or the method of going back down
was arbitrary. There was no exercise instructor especially assigned.
최주헌 외. 체중조절을 위한 3주간 계단 오르기의 효과
제34권 제2호 2016 187
Table 2. Changes of subjects (average)
Variable Before (A) After (B) Difference (SD) Rate of change*
Weight (kg) 75.52 72.18 3.35 (0.79) 4.44
Body fat mass (%) 28.32 25.80 2.52 (1.36) 8.91
Muscle quantity (kg) 25.95 25.70 0.25 (0.57) 0.96
Pulmonary functio n tests
FVC (L) 3.98 3.87 0.11 (0.43) 2.64
(L) 3.24 3.19 0.05 (0.21) 1.54
Volume of muscle and fat (by CT)
Thigh muscle (Rt, mm
) 11,967.01 11,941.32 25.69 (159.5) 0.21
Thigh muscle (Lt, mm
) 12,117.63 11,925.29 192.34 (244.2) 1.59
Thigh fat (Rt, mm
) 11,310.01 10,944.63 365.38 (788.1) 3.23
Thigh fat (Lt, mm
) 11,204.96 9,698.05 1,506.91 (982.6) 13.45
Lower-extremity strength by Biodex
Peak torque (60/sec, Rt, extension) 105.45 110.60 5.15 (17.54) 4.88
Peak torque (60/sec, Rt, flexion) 49.35 58.58 9.22 (8.66) 18.69
Peak torque (60/sec, Lt, extension) 92.88 97.78 4.90 (25.00) 5.28
Peak torque (60/sec, Lt, flexion) 45.48 52.38 6.90 (10.67) 15.17
Peak torque (180/sec, Rt, extension) 75.68 77.25 1.58 (12.97) 2.08
Peak torque (180/sec, Rt, flexion) 35.93 44.03 8.10 (9.01) 22.55
Peak torque (180/sec, Lt, extension) 72.65 74.10 1.45 (15.57) 2.00
Peak torque (180/sec, Lt, flexion) 35.63 40.60 4.98 (8.37) 13.96
SD: standard deviation, FVC: forced vital capacity, FEV
: forced expiratory volume in 1 second, CT: computed tomo
Rt: right thigh, Lt: left thigh.
*Change rate=(BA)/A×100.
The Seoul National University-Boramae Hospital Institutional
Review Board approved this study.
1. Assessing obesity
We measured their body weight, and body fat percentage, and
muscle quantity was assessed with eight-polar bioelectrical
impedance (InBody 3.0, Biospace, Seoul, Korea).
2. Assessing pulmonary function
Pulmonary Function Test was performed using standard
laboratory techniques according to guidelines by the American
Thoracic Society. The vital capacity and its subdivisions were
measured from a slow exhalation with a rolling seal spirometer
(Sensormedics 2800, SensorMedics Co., Yorba Linda, CA, USA).
Forced vital capacity (FVC) and forced expiratory volume in
1 second (FEV
) were obtained from forced expiration into the
3. Assessing lower limb muscle strength
We measured the peak torque of extensor and flexor at knee
joint via Biodex (Shirley, NY, USA) measuring right and left
respectively in load speed 60 degree/sec and 180 degree/sec with
extension and flexion five times and 10 times respectively.
4. Asse ssing thigh muscle and fat quantity
CT was used to measure cross-sectional area of mid-thigh bone,
muscle, and fat tissue and to characterize muscle attenuation.
With the subject supine, a 10-mm cross-sectional scan of both
legs was obtained, located at the midpoint between the anterior
iliac crest and the patella. In image analysis, area of bone, adipose
tissue, and skeletal muscle were measured by selecting the
following regions of interest, defined by the following attenuation
200 Hounsfield units (HU) for bone,
20 to
190 HU
for adipose tissue, and 0
100 HU for muscle; mean muscle
attenuation was determined from all pixels within this range.
5. Results
After 3-week exercise, the changes of subjects are shown (Table
2). The body weight of the four participants was reduced by
3.35 kg on average (SD, 0.79), and body fat mass by 2.53 kg
J Choi, et al. Effects of Three-Week Stair Climbing Exercise for Weight Control: A Case Series Study
188 대한스포츠의학회지
(SD, 1.36). The slight loss of thigh fat (right thigh, 3.2%; left
thigh, 13.4%) was confirmed by thigh CT, and strength of lower
extremities was improved about 5%. However, the thigh muscle
did not change significantly and FVC and FEV
were reduced
by 2.6% and 1.5%, respectively. Although it seems that pulmonary
functions of participants have decreased on average, the decrease
results from that of one of four participants (subject C), which
may be due to insufficient compliance in the test. And participants
reported their pulmonary function to be improved subjectively,
and no side effect or harm were reported due to the exercise.
It has been already implied that stair climbing have close
relationship with muscle strength or pulmonary function, the key
factors of controlling overweight and obesity. There have been
many studies about stair climbing as a test of muscle capacity
or pulmonary function
. We, however, focused on the aspects
of stair climbing as a modality improving physical function in
itself. We performed a study before, in which we selected one
male and one female subjects in their forties, measured their
blood pressure, heart rate and oxygen saturation, let them climb
up the 108 stairs in a subway station having no turn in 1 minute,
and took same measurement. As a result, blood pressure of the
male subject did not change significantly from 129/88 mm Hg
to 122/71 mm Hg, whereas heartrate increased from 80/min to
106/min, and blood pressure of the female subject changed from
105/67 mm Hg to 115/78 mm Hg, heartrate from 69/min to 90/min.
So, we could observe 60%
90% of maximum heartrate for the
age, and infer that continuing stair climbing could be a proper
form of aerobic exercise. After that, this study has been designed
to check further effect of stair climbing in various health indicators,
and it has the significance in inspecting direct relationships of
those indicators.
But it might be jumping to the conclusion that climbing stairs
has ‘proved’ to be effective for the weight loss only based on
this study because of some limitations. Our study has intrinsic
limitation in the fact that it is merely ‘case study.’ Only four
people as a target may not be representative. As a matter of
fact, this sample size cannot have statistical significance even
with non-parametric test like Wilcoxon signed-rank test (p
and in order to assure statistical significance we require at least
a sample size of 6 or more in Wilcoxon signed-rank test. In
addition, the nutrition of subjects was not so strictly controlled
that the possibility may not be ruled out that changes of indicator
were affected by the diet. In fact, no significant growth of thigh
muscle can be regarded as the effect of exercise alone not followed
by adequate protein ingestion. In further study, homogenous group
or the larger number of subjects will be needed for inspecting
more sophisticated relationship. And still stricter diet control has
to be introduced.
In our study, participants consist of the office worker, the
housewives, one of whom became overweight after the childbirth,
and all of them have sedentary life style in common. They have
little extra physical activity except irregular leisure time of 1
times a month. But continuous climbing stairs for 3 weeks in
daily life offers them benefits like losing body weight, strengthening
of lower extremity and losing of thigh fat without separated physical
activity. Despite all the limitations of this study, it can be suggested
that stair climbing can be an effective way to lose weight for
the people who have sedentary life style.
Conflict of Interest
No potential conflict of interest relevant to this article was
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[Purpose] Obesity is a global health problem and is associated with a multitude of complications. This study was designed to determine changes in cardiopulmonary functions after aerobic and anaerobic exercise training in obese subjects. [Subjects and Methods] Forty obese subjects, whose ages ranged between 18 and 25 years, were divided into 2 equal groups: group A received aerobic exercise training in addition to dietary measures, and group B received anaerobic exercise training for 3 months in addition to dietary measures. Measurements of systolic blood pressure, diastolic blood pressure, heart rate, maximum voluntary ventilation, maximal oxygen consumption, and body mass index were obtained for both groups before and after the exercise program. [Results] The mean body mass index, systolic blood pressure, diastolic blood pressure, heart rate, and maximal oxygen consumption decreased significantly, whereas the mean maximum voluntary ventilation increased significantly after treatment in group A. The mean maximum voluntary ventilation also increased significantly after treatment in group B. There were significant differences between the mean levels of the investigated parameters in groups A and B after treatment. [Conclusion] Aerobic exercise reduces weight and improves cardiopulmonary fitness in obese subjects better than anaerobic exercise.
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The prevalence of obesity was estimated based on self-reported height and weight recorded in the Community Health Survey (CHS), a nationwide survey which began in 2008. This study was conducted to evaluate the extent and consistency of underestimation in obesity and overweight prevalences in CHS compared to the Korea National Health and Nutrition Examination Survey (KNHANES) data.
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Background: Among the current instruments used to assess stair ambulation, none were observed that specifically evaluated the quality of movement or biomechanical strategies adopted by stroke patients. Objective: To evaluate the content validity of a clinical instrument designed to identify the qualitative and kinematic characteristics and strategies adopted by stroke patients during stair ascent and descent. Method: The first developed version, which comprised 80 items, had its content evaluated by an expert panel, which was composed of 9 well-known national and international professionals who are involved in stroke rehabilitation. The content validity index (CVI) and modified Kappa coefficients were employed for the statistical analyses. The items that demonstrated a CVI≥0.80 and Kappa≥0.75 were considered valid. Results: The content validation was performed in three stages. The final version of the instrument consisted of 38 items, which were divided into descriptive (8 items), a General Characteristics Domain (16 items) and adopted strategies (14 items) during stair ascent and descent. The total scores ranged from zero to 70 and zero to 74 for ascent and descent, respectively. Lower scores corresponded with better performance. Conclusion: Despite the satisfactory results obtained during the process of content validation, other psychometric properties of the instrument are necessary and must be evaluated.
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Background: In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. Methods: We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Findings: Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Interpretation: Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Funding: Bill & Melinda Gates Foundation.
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OBJECTIVE To evaluate the effects of two low-fat hypocaloric diets differing in the carbohydrate-to-protein ratio, with and without resistance exercise training (RT), on weight loss, body composition, and cardiovascular disease (CVD) risk outcomes in overweight/obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 83 men and women with type 2 diabetes (aged 56.1 ± 7.5 years, BMI 35.4 ± 4.6 kg/m2) were randomly assigned to an isocaloric, energy-restricted diet (female subjects 6 MJ/day, male subjects 7 MJ/day) of either standard carbohydrate (CON; carbohydrate:protein:fat 53:19:26) or high protein (HP; 43:33:22), with or without supervised RT (3 days/week) for 16 weeks. Body weight and composition, waist circumference (WC), and cardiometabolic risk markers were assessed. RESULTS Fifty-nine participants completed the study. There was a significant group effect (P ≤ 0.04) for body weight, fat mass, and WC with the greatest reductions occuring in HP+RT (weight [CON: −8.6 ± 4.6 kg, HP: −9.0 ± 4.8 kg, CON+RT: −10.5 ± 5.1 kg, HP+RT: −13.8 ± 6.0 kg], fat mass [CON: −6.4 ± 3.4 kg, HP: −6.7 ± 4.0 kg, CON+RT: −7.9 ± 3.7 kg, HP+RT: −11.1 ± 3.7 kg], and WC [CON: −8.2 ± 4.6 cm, HP: −8.9 ± 3.9 cm, CON+RT: −11.3 ± 4.6 cm, HP+RT: −13.7 ± 4.6 cm]). There was an overall reduction (P < 0.001) in fat-free mass (−2.0 ± 2.3 kg), blood pressure (−15/8 ± 10/6 mmHg), glucose (−2.1 ± 2.2 mmol/l), insulin (−4.7 ± 5.4 mU/l), A1C (−1.25 ± 0.94%), triglycerides (−0.47 ± 0.81 mmol/l), total cholesterol (−0.67 ± 0.69 mmol/l), and LDL cholesterol (−0.37 ± 0.53 mmol/l), with no difference between groups (P ≥ 0.17). CONCLUSIONS An energy-restricted HP diet combined with RT achieved greater weight loss and more favorable changes in body composition. All treatments had similar improvements in glycemic control and CVD risk markers.
Context: Few objective data are available regarding strength and movement patterns in individuals with articular cartilage defects (ACDs) of the knee. Objectives: To test the following hypotheses: (1) The involved limb of individuals with ACDs would demonstrate lower peak knee-flexion angle, peak internal knee-extension moment, and peak vertical ground-reaction force (vGRF) than the contralateral limb and healthy controls. (2) On the involved limb of individuals with ACDs, quadriceps femoris strength would positively correlate with peak knee-flexion angle, peak internal knee-extension moment, and peak vGRF. Design: Cross-sectional. Setting: Biomechanics research laboratory. Participants: 11 individuals with ACDs in the knee who were eligible for surgical cartilage restoration and 10 healthy controls. Methods: Quadriceps femoris strength was quantified as peak isometric knee-extension torque via an isokinetic dynamometer. Sagittal-plane knee kinematics and kinetics were measured during the stance phase of stair ascent with 3-dimensional motion analysis. Main outcome measures: Quadriceps strength and knee biomechanics during stair ascent were compared between the involved and contralateral limbs of participants with ACD (paired t tests) and with a control group (independent-samples t tests). Pearson correlations evaluated relationships between strength and stair-ascent biomechanics. Results: Lower quadriceps strength and peak internal knee-extension moments were observed in the involved limb than in the contralateral limb (P < .01) and the control group (P < .01). For the involved limb of the ACD group, quadriceps femoris strength was strongly correlated (r = .847) with involved-limb peak internal knee-extension moment and inversely correlated (r = -.635) with contralateral peak vGRF. Conclusions: Individuals with ACDs demonstrated deficits in quadriceps femoris strength with associated alterations in movement patterns during stair ascent. The results of this study are not comprehensive; further research is needed to understand the physiological characteristics, activity performance, and movement quality in this population.
Background: The health and fitness benefits associated with short, intermittent bouts of exercise accumulated throughout the day have been seldom investigated. Stair climbing provides an ideal model for this purpose. Methods: Twenty-two healthy female volunteers (18-22 years) were randomly assigned to control (N = 10) or stair-climbing (N = 12) groups. Stair climbers then underwent a 7-week stair-climbing program, progressing from one ascent per day in week 1 to six ascents per day in weeks 6 and 7, using a public access staircase (199 steps). Controls were instructed to maintain their normal lifestyle. Standardized stair-climbing tests were administered to both groups immediately before and after the program. Each paced ascent lasted 135 s, during which oxygen uptake (VO(2)) and heart rate (HR) were monitored continuously. Blood lactate concentration was also measured immediately following each test ascent. Fasting blood samples from before and after the program were analyzed for serum lipids. Data were analyzed using a two-way ANOVA with repeated measures. Results: Relative to the insignificant changes in the control group, the stair-climbing group displayed a rise in HDL cholesterol concentration (P<0.05) and a reduced total:HDL ratio (P<0.01) over the course of the program. VO(2) and HR during the stair-climbing test were also reduced, as was blood lactate (all P<0.01). Conclusion: A short-term stair-climbing program can confer considerable cardiovascular health benefits on previously sedentary young women, lending credence to the potential public health benefits of this form of exercise.
Although claudication pain and hemodynamic responses to exercise are related to the degree of arterial narrowing in the lower extremities, the nature of these responses to different exercise tasks and intensities is less clear. Thus, the purpose of this study was to compare claudication and hemodynamic responses to graded walking, level walking, and stair climbing over a range of exercise intensities. Ten patients with peripheral vascular occlusive disease performed five tests within each of the three exercise tasks. Similar values of oxygen consumption were obtained among exercise tasks at each intensity (p = ns). Time to onset of claudication pain and to maximal pain were similar among exercise tasks (p = ns), and both demonstrated a curvilinear decrease as intensity increased (p < 0.05). Foot transcutaneous oxygen tension, ankle systolic blood pressure, and ankle/brachial systolic pressure index were also similar among the three exercise tasks (p = ns); however, each decreased linearly as exercise intensity increased (p < 0.05). Thus, in peripheral vascular occlusive disease, the imbalance between oxygen delivery to the exercising lower extremity musculature and the local metabolic demand is similar during different weight-bearing activities. Second, even though the peripheral circulation is progressively impaired with increased exercise intensity, anaerobic metabolism in the ischemic lower extremity musculature may prevent a continual decline in claudication times. The clinical implication is that a more thorough assessment of the functional limitations imposed by claudication pain is not obtained by using different types of weight-bearing exercise tests as opposed to using on ly one type.