Effects of Long-term Exercise Rehabilitation on Claudication Distances in Patients With Peripheral Arterial Disease: A Randomized Controlled Trial

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Abstract
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. 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. 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). 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.