Effects of long-term exercise rehabilitation on claudication distances in patients with peripheral arterial disease: a randomized controlled trial.
OBJECTIVE
To determine if improvements in physical function and peripheral circulation after 6 months of exercise rehabilitation could be sustained over a subsequent 12-month maintenance exercise program in older patients with intermittent claudication.


METHODS
Seventeen patients randomized to exercise rehabilitation and 14 patients randomized to usual care control completed this 18-month study. Patients exercised three times per week during the first 6 months of a progressive exercise program, followed by two times per week during the final 12 months of a maintenance program. Patients were studied at baseline, 6 months, and 18 months during the study.


RESULTS
Eighteen months of exercise rehabilitation increased the initial claudication distance by 373 meters (189%) (P <.001), the absolute claudication distance by 358 meters (80%) (P <.001), walking economy by 11% (P <.001), 6-minute walk distance by 10% (P <.001), daily physical activity by 31%, and maximal calf blood flow by 18% (P <.001). These changes were similar to those found after 6 months of exercise rehabilitation (P = NS), and were significantly greater than the changes in the control group throughout the study (P <.05).


CONCLUSIONS
Improvements in claudication distances, walking economy, 6-minute walk distance, physical activity level, and peripheral circulation after 6 months of exercise rehabilitation are sustained for an additional 12 months in older patients with intermittent claudication using a less frequent exercise maintenance program.
Gardner
Andrew W
AW
Claude D. Pepper Older Americans Independence Center, Department of Medicine, Division of Gerontology, University of Maryland, Baltimore, USA. awgardner@ou.edu
Katzel
Leslie I
LI
Sorkin
John D
JD
Goldberg
Andrew P
AP
D000368:Aged; D005081:Exercise Therapy / Q000379:methods; D006801:Humans; D007383:Intermittent Claudication / Q000534:rehabilitation*; D007866:Leg / Q000098:blood supply; D012039:Regional Blood Flow; D013997:Time Factors; D016138:Walking / Q000502:physiology*