Treatment of intermittent claudication: the impact on quality of life.
OBJECTIVE
To measure changes in claudicant's quality of life after surgery, angioplasty or unsupervised exercise. To explore the relationship between clinical indicators of limb perfusion and patient's perception of health change.


METHODS
Prospective study.


METHODS
University Hospital vascular outpatients.


METHODS
202 claudicants referred for Duplex of lower limb arterial disease over a 12 month period. The short form 36 questionnaire was used to determine quality of life. Ankle pressures and walking distances were determined.


RESULTS
The SF-36 was completed by 186 patients (92%) before and after treatment (34 operative patients, 74 angioplasty and 78 treated by exercise alone). Baseline quality of life was worse in surgical patients. Unsupervised exercise produced minimal changes in quality of life. Angioplasty and operation produced similar, significant improvements in physical functioning and pain. Changes in physical function or pain scores were unrelated to changes in ankle pressure.


CONCLUSIONS
Unsupervised exercise programs are unlikely to significantly improve patient's quality of life. The benefits of surgery and angioplasty support a relaxation in the indications for investigation and treatment of claudicants. Patients with impaired perceived health should not be denied treatment on the basis of preintervention ankle pressure or walking distance alone.
Currie
I C
IC
Department of Vascular Surgery, Bristol Royal Infirmary, U.K.
Wilson
Y G
YG
Baird
R N
RN
Lamont
P M
PM
D000704:Analysis of Variance; D000800:Angioplasty, Balloon / Q000706:statistics & numerical data; D005080:Exercise Test / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000628:therapy*; D007866:Leg / Q000000981:diagnostic imaging; D008297:Male; D011788:Quality of Life; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D018616:Ultrasonography, Doppler, Duplex; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data