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 .
Effect of lower extremity blood pressure on physical functioning in patients who have intermittent claudication. The Chicago Claudication Outcomes Research Group.
PURPOSE Claudication patients ' perceptions of walking impairment often influence recommendations for peripheral bypass and angioplasty . The actual relationship between lower extremity blood flow and physical functioning , however , has rarely been explicitly studied . METHODS Patients were enrolled at a visit to one of 16 vascular surgery offices and clinics that participated in a prospect i ve outcomes study . A total of 555 patients ( 445 men and 110 women ) with an abnormal ankle-brachial index ( ABI ) , none of whom had had previous leg revascularization or symptoms of rest pain , skin ulcers , or gangrene , completed the SF36 Health Survey and the Peripheral Arterial Disease Walking Impairment Question naire ( WIQ ) . Stepwise multiple regression analysis was used to test the statistical significance and strength of association between patients ' ABI level and SF36 physical functioning ( PF ) and WIQ community walking distance scores , controlled for sociodemographic characteristics and the presence and severity of comorbid conditions . RESULTS Univariate correlations with ABI were modest but significant ( PF score , r = 0.12 , p = 0.004 ; WIQ distance score , r = 0.18 , p < 0.001 ) . ABI was a very significant predictor of both PF ( b = 18.8 ; p = 0.001 ) and WIQ scores ( b = 0.33 ; p < 0.0001 ) in the multiple regression analysis . Other positive predictors of PF scores were high-school graduation and male sex . Negative predictors of PF scores were heart , lung , and cerebrovascular disease ; knee arthritis and chronic back pain ; and enrollment at a Veterans Administration clinic rather than a private community or academic office . CONCLUSION Cross-sectional findings indicate that a 0.3 improvement in ABI is associated with an average improvement of 5.6 % in PF or 10.3 % in WIQ distance score . However , proper selection of individual c and i date s for interventional therapy , that is , those patients who have lower ABIs , lower initial functioning , and fewer disabling comorbidities would be predicted to produce a much greater functional benefit . Surgeons should make a rigorous functional evaluation when recommending interventional management of claudication
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 .