title: The effect of exercises on walking distance of patients with intermittent claudication: a study of randomized clinical trials.
abstract: OBJECTIVE
  There is no consensus about the indication for exercises for patients with intermittent claudication of the lower extremity and the characteristics of an exercise program to improve walking distance. The effect of walking is assessed by a systematic review of randomized clinical trials.
  
  
  METHODS
  Literature databases were accessed using the relevant key words. The references of identified articles were screened for additional studies. A checklist was developed to screen the studies with respect to the variables of interest. A methodological assessment form was developed to assess the methodological quality of the studies (maximum possible score: 100).
  
  
  RESULTS
  Eighty-two articles were identified, of which 21 studies were considered relevant for inclusion in the review. Following the analysis of the articles, 11 studies were for various reasons eliminated, leaving 10 studies for the systematic review. The score for methodological quality of the studies ranged from 47 to 75 (mean = 62.5, SD = 8.5). Percentage of improvement in walking distance or time ranged from 28% to 210% (mean = 105%, SD = 55.8%).
  
  
  CONCLUSIONS
  All studies showed that walking exercises improved walking distance in patients with intermittent claudication. Further research is needed to determine the optimal exercise program, the effect of adherence to the treatment protocol, and the duration of the effects following a formal exercise program.
authors.affiliation: Dutch National Institute of Allied Health Professions, Amersfoort, The Netherlands. npi@pi.net
authors.forename: J W
authors.initials: JW
authors.lastname: Brandsma
authors.forename: B G
authors.initials: BG
authors.lastname: Robeer
authors.forename: S
authors.initials: S
authors.lastname: van den Heuvel
authors.forename: B
authors.initials: B
authors.lastname: Smit
authors.forename: C H
authors.initials: CH
authors.lastname: Wittens
authors.forename: R A
authors.initials: RA
authors.lastname: Oostendorp
mesh_terms: D005081:Exercise Therapy; D006801:Humans; D007383:Intermittent Claudication / Q000534:rehabilitation*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D016138:Walking