title: Does supervised exercise offer adjuvant benefit over exercise advice alone for the treatment of intermittent claudication? A randomised trial.
abstract: OBJECTIVE
  Exercise advice is the main treatment for symptom relief in the UK for patients with mild to moderate Intermittent Claudication (IC). Would a weekly exercise and motivation class for 6 months offer adjuvant benefit over written and verbal exercise advice alone?
  
  
  METHODS
  Fifty-nine patients attending a regional vascular centre for whom IC was the main factor affecting mobility were randomised to either exercise advice alone (n=30) or exercise advice with a once a week 45 min supervised exercise/motivation class (n=29). The mean age was 68 years. Baseline and 6-month assessment included a Quality of Life Questionnaire--the Short-Form-36, the Charing Cross Symptom Specific Claudication Questionnaire (CCCQ) and treadmill walking distance (3.5 km/h 12%).
  
  
  RESULTS
  At 6-month follow-up the supervised exercise group had improved their treadmill walking by 129% compared to 69% in the advice alone group (p=0.001). This significant improvement was maintained at the subsequent 9 and 12-month follow-up assessments. By the 9-month stage the advice only group CCCQ score had improved 16% from baseline, while the supervised exercise group had a significantly better 43% improvement in base line score (p<0.05). Self reported frequency of walks was higher in the exercise class group being significant for improvement in CCCQ score.
  
  
  CONCLUSIONS
  A weekly, supervised exercise and motivation class for a 6-month period provides a significant improvement in patients' symptoms, quality of life, and distance walked compared with advice alone and this improvement continues after attendance at class has ceased.
authors.affiliation: Department of Vascular Surgery, Imperial College School of Medicine, Charing Cross Hospital, London, UK.
authors.forename: D R
authors.initials: DR
authors.lastname: Cheetham
authors.forename: L
authors.initials: L
authors.lastname: Burgess
authors.forename: M
authors.initials: M
authors.lastname: Ellis
authors.forename: A
authors.initials: A
authors.lastname: Williams
authors.forename: R M
authors.initials: RM
authors.lastname: Greenhalgh
authors.forename: A H
authors.initials: AH
authors.lastname: Davies
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007383:Intermittent Claudication / Q000534:rehabilitation / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life