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 .
Design of the multicenter standardized supervised exercise training intervention for the ‘CLaudication: Exercise Vs Endoluminal Revascularization (CLEVER) study’
Abstract The CLaudication :  Exercise Vs Endoluminal Revascularization ( CLEVER ) study is the first r and omized , controlled , clinical , multicenter trial that is evaluating a supervised exercise program compared with revascularization procedures to treat claudication . In this report , the methods and dissemination techniques of the supervised exercise training intervention are described . A total of 217 participants are being recruited and r and omized to one of three arms : ( 1 ) optimal medical care ; ( 2 ) aortoiliac revascularization with stent ; or ( 3 ) supervised exercise training .  Of the enrolled patients , 84 will receive supervised exercise therapy . Supervised exercise will be administered according to a protocol design ed by a central CLEVER exercise training committee based on vali date d methods previously used in single center r and omized control trials . The protocol will be implemented at each site by an exercise committee member using training methods developed and st and ardized by the exercise training committee . The exercise training committee review s progress and compliance with the protocol of each participant weekly . In conclusion , a multicenter approach to disseminate the supervised exercise training technique and to evaluate its efficacy , safety and cost-effectiveness for patients with claudication due to peripheral arterial disease ( PAD ) is being evaluated for the first time in CLEVER . The CLEVER study will further establish the role of supervised exercise training in the treatment of claudication result ing from PAD and provide st and ardized methods for use of supervised exercise training in future PAD clinical trials as well as in clinical practice
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 .