title: Performance of patients with intermittent claudication undergoing physical training, with or without an aggravation of arterial disease: retrospective cohort study.
abstract: OBJECTIVE
  This was a retrospective cohort study aiming to investigate the clinical outcome of patients with intermittent claudication undergoing physical training in whom there was an aggravation of the arterial disease.
  
  
  METHODS
  Three hundred and sixty-four patients with claudication who presented with femoropopliteal or tibioperoneal obstructions in at least 1 of the lower limbs and who did not have aortic or bilateral iliac obstructions were included. Forty patients developed new stenoses in previously spared arterial segments (confirmed by duplex scanning), which were proximal to preexisting lesions, and formed the progression group, in contrast to the stable group of patients (n = 324) who did not exhibit this worsening of the disease. Follow-up was 276 and 277 days for stable and progression groups, respectively. All patients underwent an unsupervised program of submaximal walking 4 days a week. Changes in maximal walking distance at a progressive treadmill test were appraised during follow-up, with special interest directed to the periods between admission, diagnosis of arterial worsening, and the end of follow-up.
  
  
  RESULTS
  Performance was not significantly different between groups during the entire follow-up period. Furthermore, patients with claudication who evolved with progression of their arteriopathy did not present a reduction of their maximal walking distance in response to the development of new arterial lesions at any time during their follow-up.
  
  
  CONCLUSIONS
  Worsening of the peripheral arterial disease in patients with claudication undergoing physical training, manifested as de novo arterial occlusion in proximal and previously spared segments, does not imply in an impairment of their claudication distance.
authors.affiliation: Vascular Surgery Division, São Paulo University Medical School, São Paulo, SP, Brazil. drrosoky@terra.com.br
authors.forename: Ruben M A
authors.initials: RM
authors.lastname: Rosoky
authors.forename: Nelson
authors.initials: N
authors.lastname: Wolosker
authors.forename: Pedro
authors.initials: P
authors.lastname: Puech-Leão
mesh_terms: D000368:Aged; D004812:Epidemiologic Methods; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000534:rehabilitation*; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*