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 .
Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication.
BACKGROUND To compare angioplasty ( PTA ) , supervised exercise ( SEP ) and PTA + SEP in the treatment of intermittent claudication ( IC ) due to femoropopliteal disease . METHODS Over a 6-year period , 178 patients ( 108 men ; median age , 70 years ) with femoropopliteal lesions suitable for angioplasty  were r and omized to PTA , SEP , or PTA + SEP . Patients were assessed prior to and at 1 and 3 months post treatment . ISCVS outcome criteria ( ankle pressures , treadmill walking distances ) and quality of life ( QoL ) question naires ( SF-36 and VascuQoL ) were analyzed . RESULTS All groups were well matched at baseline . Twenty-one patients withdrew . Results are as follows : Intragroup analysis : All groups demonstrated significant clinical and QoL improvements ( Friedman test , p < 0.05 ) . SEP ( 60 patients , 8 withdrew)-62.7 % of patients ( n = 32 ) improved following treatment [ 20 mild , 9 moderate , 3 marked ] , 27.4 % ( n = 14 ) demonstrated no improvement , and 9.8 % ( n = 5 ) deteriorated . PTA  ( 60 patients , 3 withdrew)-66.6 % patients ( n = 38 ) improved following treatment [ 19 mild , 10 moderate , 9 marked ] , 22.8 % ( n = 13 ) demonstrated no improvement , and 10.5 % ( n = 6 ) deteriorated . PTA + SEP ( 58 patients , 10 withdrew)-81.6 % of patients ( n = 40 ) improved following treatment [ 10 mild , 17 moderate , 3 marked ] , 14.2 % ( n = 7 ) demonstrated no improvement , and 4.0 % ( n = 2 ) deteriorated . Intergroup analysis : PTA + SEP produce a much greater improvement in clinical outcome measures than PTA or SEP alone , but there was no significant QoL advantage ( Kruskal-Wallis test , p > 0.05 ) . CONCLUSION SEP should be the primary treatment for the patients with claudication and PTA should be supplemented by an SEP
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 .