Based on a low quality of evidence , home-based supervised exercise may lead to less improvement in maximum and pain-free walking distance , and in more improvement in daily life walking capacity , compared with hospital-based supervised exercise .
Home-based supervised exercise may improve maximum and pain-free walking distance compared with " go home and walk advice " and result in little or no difference in health-related quality of life and functional walking capacity compared with hospital-based supervised exercise or " go home and walk advice " .
OBJECTIVE To evaluate the effects of home-based supervised exercise vs hospital-based supervised exercise , and the effects of home-based supervised exercise vs unsupervised " go home and walk advice " on daily life and corridor-walking capacity , health-related quality of life and patient-reported functional walking capacity in patients with intermittent claudication .
Diabetic women are poor responders to exercise rehabilitation in the treatment of claudication.
BACKGROUND It is not clear whether subgroups of patients with peripheral artery disease ( PAD ) and claudication respond more favorably to exercise rehabilitation than others . We determined whether sex and diabetes were factors associated with the response to exercise rehabilitation in patients with claudication . METHODS Eighty patients were r and omized to home-based and supervised exercise programs , and 60 finished with complete exercise intervention data . Exercise consisted of intermittent walking to near maximal claudication pain for 3 months . Primary outcome measures included claudication onset time ( COT ) and peak walking time . Patients were partitioned into diabetic and nondiabetic groups and then further partitioned by sex to form four groups . RESULTS Overall ,  exercise adherence  was high ( 84 % ) , and there was no significant difference ( P > .05 ) in the amount of exercise completed among the four groups . All groups had significant improvements ( P < .05 ) in COT and peak walking time after exercise rehabilitation , except for diabetic women ( P > .05 ) . Only 37 % of women with diabetes had an increase in COT compared with 100 % of men with diabetes ( P < .01 ) , and their risk ratio for nonresponse was 9.2 ( P < .0001 ) . CONCLUSIONS Women with PAD and claudication , particularly those with diabetes , represent a vulnerable subgroup of patients who respond poorly to a program of exercise rehabilitation .  Diabetic women with PAD and claudication may need a greater dose of exercise or another intervention separate from or in combination with exercise to elicit improvements in claudication measures that are similar to nondiabetic women and to diabetic and nondiabetic men
Based on a low quality of evidence , home-based supervised exercise may lead to less improvement in maximum and pain-free walking distance , and in more improvement in daily life walking capacity , compared with hospital-based supervised exercise .
Home-based supervised exercise may improve maximum and pain-free walking distance compared with " go home and walk advice " and result in little or no difference in health-related quality of life and functional walking capacity compared with hospital-based supervised exercise or " go home and walk advice " .
OBJECTIVE To evaluate the effects of home-based supervised exercise vs hospital-based supervised exercise , and the effects of home-based supervised exercise vs unsupervised " go home and walk advice " on daily life and corridor-walking capacity , health-related quality of life and patient-reported functional walking capacity in patients with intermittent claudication .