In claudication patients , SE is more effective than UE at improving maximal walking and claudication distances , yet there is no difference in general quality of life or patient-reported community-based walking .
BACKGROUND Supervised exercise ( SE ) is widely accepted as an effective therapy for intermittent claudication ( IC ) , but its use is limited by cost .
Unsupervised exercise ( UE ) represents a less costly alternative .
We assessed the comparative effectiveness of SE vs UE in patients with IC .
Exercise training for intermittent claudication: does it adversely affect biochemical markers of the exercise-induced inflammatory response?
OBJECTIVES To identify a stable biochemical marker of disease severity in patients with intermittent claudication and to use these findings to assess the effect of therapeutic exercise training . DESIGN Case-control study : prospect i ve r and omised-controlled trial of exercise training . MATERIAL S AND METHODS Plasma fibrinogen , serum amyloid A protein ( SAA ) , C-reactive protein ( CRP ) and urinary albumin-creatinine ratio ( ACR ) were measured in 67 claudicants and 15 controls . Twenty-two patients were r and omised to supervised exercise training and 17 r and omised to observation .  Subjects were review ed at 3 , 6 and 12 months . RESULTS The median ( interquartile range ) baseline fibrinogen was 3.7 g/l ( 3.3 - 4.25 ) in claudicants and 3.5 g/l ( 2.9 - 3.95 ) in controls ( p = 0.045 ) ; CRP was 4.7 mg/l ( 2.2 - 9.0 ) and 2.1 mg/l ( 1.0 - 2.8 ) , respectively ( p < 0.0001 ) ; SAA was 72 mg/l ( 35 - 132 ) and 30 mg/l ( 20 - 89 ) ( p = 0.0009 ) . Claudicants showed an increased urinary ACR following treadmill exercise ( Wilcoxon , p < 0.0001 ) with no change in controls . Exercise training reduced SAA at 6 months , CRP at 3 months and progressively attenuated the post-exercise increase in ACR . No similar changes were found in controls . CONCLUSIONS Repetitive low- grade inflammatory events in claudicants lead to elevation of serum acute-phase proteins .  Exercise training is associated with symptomatic improvement and reduction inflammatory markers . The concern that exercise has adverse systemic effects therefore seems to be unjustified
In claudication patients , SE is more effective than UE at improving maximal walking and claudication distances , yet there is no difference in general quality of life or patient-reported community-based walking .
BACKGROUND Supervised exercise ( SE ) is widely accepted as an effective therapy for intermittent claudication ( IC ) , but its use is limited by cost .
Unsupervised exercise ( UE ) represents a less costly alternative .
We assessed the comparative effectiveness of SE vs UE in patients with IC .