Data showed improvements secondary to exercise in ' physical function ' and ' general health ' .
The other domains - ' role physical ' , ' bodily pain ' , ' vitality ' , ' social ' , ' role emotional ' , and ' mental health ' - did not show improvement at six months .
Although results showed significant heterogeneity between trials , population s and outcomes were comparable overall , with findings relevant to the claudicant population .
High- quality evidence shows that exercise programmes provided important benefit compared with placebo or usual care in improving both pain-free and maximum walking distance in people with leg pain from IC who were considered to be fit for exercise intervention .
Exercise did not improve ABI , and we found no evidence of an effect of exercise on amputation or mortality .
Exercise may improve quality of life when compared with placebo or usual care .
BACKGROUND Exercise programmes are a relatively inexpensive , low-risk option compared with other , more invasive therapies for treatment of leg pain on walking ( intermittent claudication ( IC ) ) .
This is the fourth up date of a review first published in 1998 .
OBJECTIVES Our goal was to determine whether an exercise programme was effective in alleviating symptoms and increasing walking treadmill distances and walking times in people with intermittent claudication .
Secondary objectives were to determine whether exercise was effective in preventing deterioration of underlying disease , reducing cardiovascular events , and improving quality of life .
Vitamin C prevents endothelial dysfunction induced by acute exercise in patients with intermittent claudication.
In patients with intermittent claudication , exercise is associated with a marked increase in oxidative stress , likely responsible for systemic endothelial perturbation . In 31 claudicant patients , we assessed the effect of vitamin C administration on the acute changes induced by maximal and submaximal exercise in endothelium-dependent , flow-mediated dilation ( FMD ) , and in plasma levels of thiobarbituric acid-reactive substances ( TBARS ) and soluble intercellular adhesion molecule-1 ( sICAM-1 ) . In 16 claudicants , maximal exercise reduced FMD ( from 8.5+/-0.9 to 3.7+/-0.8 % , P<0.01 ) , and increased plasma levels of TBARS ( from 1.93+/-0.06 to 2.22+/-0.1 nmol/ml , P<0.02 ) and of sICAM-1 ( from 282+/-17 to 323+/-19 ng/ml , P<0.01 ) . In eight of these patients , r and omized to vitamin C ,  exercise-induced changes in FMD and biochemistry were abolished . This beneficial effect was not observed in the eight patients r and omized to saline . In 15 patients , who walked until the onset of claudication pain ( submaximal exercise ) , and in ten control subjects , who performed maximal exercise , no changes were observed with exercise . Thus , in claudicants , vitamin C prevents the acute , systemic impairment in endothelial function induced by maximal exercise . This finding provides a rationale for trials investigating antioxidant therapy and cardiovascular risk in patients with intermittent claudication
Data showed improvements secondary to exercise in ' physical function ' and ' general health ' .
The other domains - ' role physical ' , ' bodily pain ' , ' vitality ' , ' social ' , ' role emotional ' , and ' mental health ' - did not show improvement at six months .
Although results showed significant heterogeneity between trials , population s and outcomes were comparable overall , with findings relevant to the claudicant population .
High- quality evidence shows that exercise programmes provided important benefit compared with placebo or usual care in improving both pain-free and maximum walking distance in people with leg pain from IC who were considered to be fit for exercise intervention .
Exercise did not improve ABI , and we found no evidence of an effect of exercise on amputation or mortality .
Exercise may improve quality of life when compared with placebo or usual care .
BACKGROUND Exercise programmes are a relatively inexpensive , low-risk option compared with other , more invasive therapies for treatment of leg pain on walking ( intermittent claudication ( IC ) ) .
This is the fourth up date of a review first published in 1998 .
OBJECTIVES Our goal was to determine whether an exercise programme was effective in alleviating symptoms and increasing walking treadmill distances and walking times in people with intermittent claudication .
Secondary objectives were to determine whether exercise was effective in preventing deterioration of underlying disease , reducing cardiovascular events , and improving quality of life .