Exercise for intermittent claudicationBMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7315.703 (Published 29 September 2001) Cite this as: BMJ 2001;323:703
Supervised programmes should be universally available
- A H R Stewart (AHRStewart@hotmail.com), research fellow,
- P M Lamont, consultant vascular surgeon
- Department of Surgery, Bristol Royal Infirmary, Bristol BS2 8HW
Intermittent claudication is a common condition leading to significant functional impairment and enhanced risk of cardiovascular morbidity and mortality. However, despite the functional impairment caused by intermittent claudication, the natural history in the affected limb is fairly benign. Only about 25% of patients show symptomatic deterioration and only 2% eventually lose the affected limb.1 This epidemiological evidence has led most clinicians in both primary and hospital care to manage intermittent claudication conservatively, addressing cardiovascular risk factors2 and giving advice on exercise. This may well be appropriate but merely giving advice about exercise is unlikley to be the most effective treatment.
Exercise as a treatment for intermittent claudication is not new, with improvements in walking described from as early as 1898. A recent Cochrane review of 10 randomised trials of exercise therapy estimated an overall improvement in walking distance of about 150%.3 The exercise component in all but one of these …