title: Treatment efficacy of intermittent claudication by invasive therapy, supervised physical exercise training compared to no treatment in unselected randomised patients II: one-year results of health-related quality of life.
abstract: OBJECTIVE
  to compare the effectiveness of invasive therapy, supervised physical training and no treatment in terms of health-related quality of life (HRQL) in patients with intermittent claudication (IC).
  
  
  METHODS
  a prospective, randomised, controlled study.
  
  
  METHODS
  a total of 253 unselected patients with stable IC were sequentially randomised into 3 balanced treatment groups. At 1 year follow-up data from a battery of generic and disease specific HRQL questionnaires, and global indices of quality of life and physical condition were available in 171 patients.
  
  
  RESULTS
  compared with a non-diseased reference group, claudicants were substantially limited in daily physical functioning, but little affected regarding emotional, cognitive and social functioning, or well-being. Invasive therapy yielded significantly greater improvements in some aspects of physical functioning and walk-related symptoms than training. Training was not superior to invasive therapy on any HRQL dimension and superior to no treatment on only one dimension. Treatment effects, however, were generally small-to-moderate and levels of physical dysfunction in all groups remained higher than reference values.
  
  
  CONCLUSIONS
  invasive therapy is more effective than supervised training in alleviating illness-specific symptoms and improving certain aspects of physical functioning - the primary HRQL domains impacted on by IC and the principal goals of its treatment. However, since treatment effect sizes were at most moderate and given that untreated claudicants reported at most small deterioration in HRQL, the level of evidence supporting invasive therapy is modest.
authors.affiliation: Health Care Research Unit, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Taft
authors.forename: J
authors.initials: J
authors.lastname: Karlsson
authors.forename: J
authors.initials: J
authors.lastname: Gelin
authors.forename: L
authors.initials: L
authors.lastname: Jivegård
authors.forename: R
authors.initials: R
authors.lastname: Sandström
authors.forename: B
authors.initials: B
authors.lastname: Arfvidsson
authors.forename: A G
authors.initials: AG
authors.lastname: Dahllöf
authors.forename: K
authors.initials: K
authors.lastname: Lundholm
authors.forename: M
authors.initials: M
authors.lastname: Sullivan
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D018434:Sickness Impact Profile; D016896:Treatment Outcome