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 .
Effects of home versus supervised exercise for patients with intermittent claudication.
PURPOSE This study was performed to test the efficacy of a supervised , hospital-based exercise program compared with a home-based exercise program involving minimal supervision , for both walking ability and quality of life measures in patients with exercise-limiting intermittent leg claudication . METHODS Twenty-one patients were assigned r and omly to 12 weeks of supervised exercise or to a home-based exercise group . After 12 weeks the participants in the supervised group transitioned to a home-based program . Both groups were then reevaluated at the end of 24 weeks . The initial claudication distance ( ICD ) and absolute claudication distance ( ACD ) on progressive treadmill exercise was measured at baseline , 12 weeks , and 24 weeks . Additionally , self-reported quality of life status was evaluated using the MOS SF-36 question naire . RESULTS Each group improved ( P < 0.01 ) ACD from baseline to 12 weeks , which was sustained at the 24-week follow-up . Both groups experienced similar long-term improvements ( P < 0.05 ) in ACD ( 521.5 + /- 253.4 meters to 741.9 + /- 365.6 meters for the supervised group , 532.2 + /- 263.5 meters to 715.0 + /- 394.4 meters in the home group , P not significant , between groups ) . The supervised group experienced a greater improvement ( P < 0.01 ) in the ICD after 12 weeks than the home group but not at 24 weeks . The on-site group also experienced significant improvements in ICD after 24 weeks ( P < 0.05 ) . Neither group manifested an improvement in self-reported physical function or mental health as assessed by the MOS SF-36 . CONCLUSION A structured exercise program was more effective in improving the ICD over a 24-week period than a less formal , home-based program . However , if patients are screened properly and receive adequate instruction , a home-based program can be a safe , low-cost alternative providing similar long-term ( 24 weeks ) exercise benefits in ACD
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 .