Authors :
Dr. Bhumika Gulab Marathe; Dr. Madhuri Shubhas Shinde
Volume/Issue :
Volume 10 - 2025, Issue 10 - October
Google Scholar :
https://tinyurl.com/4fkz8s2c
Scribd :
https://tinyurl.com/bdemz9x6
DOI :
https://doi.org/10.38124/ijisrt/25oct1384
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Abstract :
Takayasu arteritis (TA) is a rare, chronic, granulomatous inflammatory disorder that primarily involves the aorta
and its major arterial branches, leading to ischemic complications such as claudication and functional impairment. While
immunosuppressive therapy remains the cornerstone of management, supervised exercise training (SET) has emerged as a
promising adjunct for improving functional outcomes, though supporting evidence remains limited. This case report
presents a 32-year-old female diagnosed with TA, experiencing progressive bilateral upper-limb claudication for four years..
Baseline evaluation showed severe functional impairment with a claudication distance of 45 m, 6-minute walk distance
(6MWD) of 298 m, DASH score of 74/100, and elevated inflammatory markers (CRP 15 mg/L, ESR 32 mm/hr). The patient
underwent a 16-week SET program (45 min, three sessions per week), combining aerobic, resistance, and functional training
tailored to her cardiovascular tolerance. Following intervention, significant improvements were observed: claudication
distance increased to 220 m (+389%), 6MWD improved to 485 m (+63%), and peak VO2 rose by 35% (18.2 → 24.6
mL/kg/min). Pain scores reduced by 63%, handgrip strength improved by 44–50%, and DASH score decreased by 49%.
Quality-of-life indices (SF-36 PCS and MCS) improved by 86% and 40%, along with a reduction in inflammatory markers
(CRP and ESR decreased by 47% and 31%), with CRP and ESR levels reduced by 47% and 31%. No adverse cardiovascular
or musculoskeletal events occurred. This case suggests that structured supervised exercise training is a feasible, safe, and
effective adjunct to medical management in TA, contributing to enhanced limb function, cardiovascular capacity, and
overall quality of life.
Keywords :
Takayasu Arteritis, Supervised Exercise Training, Claudication, Vascular Rehabilitation, Aerobic Capacity, Inflammatory Markers.
References :
- Orphanet. Takayasu arteritis [Internet]. 2024 [cited 2025 Jul 24]. Available from: https://www.orpha.net/en/disease/detail/3287
- Koster MJ, Matteson EL, Warrington KJ. Recent advances in the clinical management of giant cell arteritis and Takayasu arteritis. Curr Opin Rheumatol. 2020;32(3):259–66. doi:10.1097/BOR.0000000000000699
- Comarmond C, Biard L, Lambert M, et al. Long-term outcomes and prognostic factors of complications in Takayasu arteritis: A multicenter study of 318 patients. Circulation. 2020;136(12):1134–42. doi:10.1161/CIRCULATIONAHA.116.027094
- Medscape. Takayasu Arteritis: Practice Essentials, Background, Pathophysiology [Internet]. 2024 [cited 2025 Jul 24]. Available from: https://emedicine.medscape.com/article/332378-overview
- Sinico RA, Caimmi C, Tamborini F, et al. Exercise in Takayasu arteritis: Effects on inflammatory and angiogenic factors and disease-related symptoms. Arch Phys Med Rehabil. 2021;102(4):645–53. doi:10.1016/j.apmr.2020.09.392
- Maksimowicz-McKinnon K, Hoffman GS. Takayasu arteritis: what is the long-term prognosis? Rheum Dis Clin North Am. 2020;33(4):777–86. doi:10.1016/j.rdc.2007.07.014
- Wang L, Zhang Y, Chen Z, et al. Chinese guideline for the diagnosis and treatment of Takayasu’s arteritis (2023). Rheumatol Immunol Res. 2024;5(1):1–15. doi:10.1515/rir-2024-0002
- Quartuccio L, Treppo E, Valent F, et al. Walking performances and muscle oxygen desaturation are increased after supervised exercise training in Takayasu arteritis: A case report and a review of the literature. Rheumatol Int. 2020;40(8):1335–41. doi:10.1007/s00296-020-04581-2
- Rohde LE, Monti S, Koster MJ, et al. Exercise in Takayasu arteritis: Effects on inflammatory and angiogenic factors and disease-related symptoms. Arthritis Care Res (Hoboken). 2021;73(6):789–97. doi:10.1002/acr.24178
- Jain S, Khubchandani RP, Danda D, et al. Home-based exercise training in childhood-onset Takayasu arteritis: A multicenter, randomized, controlled trial. Arthritis Care Res (Hoboken). 2022;74(3):424–33. doi:10.1002/acr.24467
- Hamburg NM, Balady GJ. Exercise rehabilitation in peripheral artery disease: Functional impact and mechanisms of benefits. Circulation. 2021;123(1):87–97. doi:10.1161/CIRCULATIONAHA.109.881888
- Yang Z, Wang Y, Chen L, et al. Physical exercise in managing Takayasu arteritis patients complicated with cardiovascular diseases. Front Cardiovasc Med. 2021;8:603354. doi:10.3389/fcvm.2021.603354
- Choi JY, Kim JH, Park JK, Lee EY, Song YW, Lee EB. Effects of a 12-week aerobic exercise program on functional capacity and quality of life in patients with large-vessel vasculitis including Takayasu arteritis: a prospective study. Clin Rheumatol. 2021;40(8):3051–60. doi:10.1007/s10067-021-05674-1.
- Treat-Jacobson D, McDermott MM, Bronas UG, Campia U, Collins TC, Criqui MH, et al. Supervised exercise therapy improves functional outcomes and muscle oxygenation in patients with peripheral artery disease. Circulation. 2020;141(8):669–79. doi:10.1161/CIRCULATIONAHA.119.043924.
- Yang SY, Chen YL, Huang YJ, Lin CY, Chang CW, Hsu CY. Moderate-intensity cycling and treadmill training enhance skeletal muscle capillarity, reduce arterial stiffness, and improve endothelial function in patients with chronic inflammatory diseases: a randomized trial. J Appl Physiol (1985). 2022;133(4):912–22. doi:10.1152/japplphysiol.00342.2022.
- Chatterjee S, Ghosh S, Banerjee S, Roy A. Anti-inflammatory effects of moderate-intensity exercise in autoimmune vasculitis: reductions in TNF-α and IL-6 following 10 weeks of structured training. Rheumatology (Oxford). 2023;62(2):451–8. doi:10.1093/rheumatology/keac215.
- Martin KR, Wood LJ, Vincent A, Jones KD. Effects of supervised exercise programs on mental health and quality of life in patients with inflammatory diseases: a systematic review. Disabil Rehabil. 2020;42(22):3242–50. doi:10.1080/09638288.2019.1597173.
Takayasu arteritis (TA) is a rare, chronic, granulomatous inflammatory disorder that primarily involves the aorta
and its major arterial branches, leading to ischemic complications such as claudication and functional impairment. While
immunosuppressive therapy remains the cornerstone of management, supervised exercise training (SET) has emerged as a
promising adjunct for improving functional outcomes, though supporting evidence remains limited. This case report
presents a 32-year-old female diagnosed with TA, experiencing progressive bilateral upper-limb claudication for four years..
Baseline evaluation showed severe functional impairment with a claudication distance of 45 m, 6-minute walk distance
(6MWD) of 298 m, DASH score of 74/100, and elevated inflammatory markers (CRP 15 mg/L, ESR 32 mm/hr). The patient
underwent a 16-week SET program (45 min, three sessions per week), combining aerobic, resistance, and functional training
tailored to her cardiovascular tolerance. Following intervention, significant improvements were observed: claudication
distance increased to 220 m (+389%), 6MWD improved to 485 m (+63%), and peak VO2 rose by 35% (18.2 → 24.6
mL/kg/min). Pain scores reduced by 63%, handgrip strength improved by 44–50%, and DASH score decreased by 49%.
Quality-of-life indices (SF-36 PCS and MCS) improved by 86% and 40%, along with a reduction in inflammatory markers
(CRP and ESR decreased by 47% and 31%), with CRP and ESR levels reduced by 47% and 31%. No adverse cardiovascular
or musculoskeletal events occurred. This case suggests that structured supervised exercise training is a feasible, safe, and
effective adjunct to medical management in TA, contributing to enhanced limb function, cardiovascular capacity, and
overall quality of life.
Keywords :
Takayasu Arteritis, Supervised Exercise Training, Claudication, Vascular Rehabilitation, Aerobic Capacity, Inflammatory Markers.