The effect of exercise compared with placebo or usual care was inconclusive on mortality , amputation and peak exercise calf blood flow due to limited data .
Angioplasty may produce greater improvements than exercise in the short term but this effect may not be sustained .
Exercise programmes were of significant benefit compared with placebo or usual care in improving walking time and distance in selected patients with leg pain from IC
BACKGROUND Exercise programmes are a relatively inexpensive , low-risk option compared with other more invasive therapies for leg pain on walking ( intermittent claudication ( IC ) ) .
OBJECTIVES To determine the effects of exercise programmes on IC , particularly in respect of reduction of symptoms on walking and improvement in quality of life .
Muscle enzyme adaptation in patients with peripheral arterial insufficiency: spontaneous adaptation, effect of different treatments and consequences on walking performance.
1 . The activities of  phosphofructokinase ( PFK ) , citrate synthetase ( CS ) , lactate dehydrogenase ( LDH ) , 3-hydroxyacyl-CoA dehydrogenase ( ACDH ) and cytochrome-c oxidase(Cyt-ox ) in the calf muscle tissue were compared in subjects with intermittent claudication ( n = 38 ) and controls ( n = 20 ) . The activities of CS , ACDH and Cyt-ox were increased and the activity of Cytox was positively correlated to the maximal walking distance ( MWD ) in the patients . 2 . Thirty-three patients with intermittent claudication were r and omized to three treatment groups : ( 1 ) operative surgery , ( 2 ) operative surgery supplemented with physical training and ( 3 ) physical training alone . Before and after 6 - 12 months of treatment , symptom-free walking distance ( SFWD ) , MWD , ankle-brachial blood pressure quotient ( ankle index ) , maximal plethysmographic calf blood flow ( MPBF ) and the activities of PFK , CS , LDH , ACDH and Cyt-ox were measured . 3 . SFWD and MWD increased in all three groups . Ankle index and MPBF increased in groups 1 and 2 , but were unchanged in group 3 . The activities of Cyt-ox and CS decreased with operation , but the activity of Cyt-ox was further augmented with training in group 3 . Overall , the change in ankle index explained 80 - 90 % of the variability in walking performance . In a separate analysis , the increased activity of Cyt-ox in group 3 was positively correlated to , and explained 31 % of the variability in , the improvement in SFWD . 4 . These findings indicate that both physical activity and a reduced calf blood flow are necessary conditions for the enzymatic adaptation to take place . A causal relationship between metabolic adaptation in the muscle tissue and walking performance is suggested . ( ABSTRACT TRUNCATED AT 250 WORDS
The effect of exercise compared with placebo or usual care was inconclusive on mortality , amputation and peak exercise calf blood flow due to limited data .
Angioplasty may produce greater improvements than exercise in the short term but this effect may not be sustained .
Exercise programmes were of significant benefit compared with placebo or usual care in improving walking time and distance in selected patients with leg pain from IC
BACKGROUND Exercise programmes are a relatively inexpensive , low-risk option compared with other more invasive therapies for leg pain on walking ( intermittent claudication ( IC ) ) .
OBJECTIVES To determine the effects of exercise programmes on IC , particularly in respect of reduction of symptoms on walking and improvement in quality of life .