Physiological and functional impact of an unsupervised but supported exercise programme for claudicants

Objectives: To evaluate an unsupervised home-based exercise programme for physiological, functional, and quality of Life impact in patients with symptomatic peripheral arterial disease. Design: Prospective cohort with exercise intervention. Materials: Human performance laboratory with non-invasive haemodynamic assessment facilities. Methods: Forty-seven patients with symptomatic peripheral arterial disease (mean age 67.6 +/- 7 years, 33 males) participated in an unsupervised home-based exercise programme. Heart rate (HR), ankle brachial blood pressure index (ABPI), leg blood flow (BF), and blood lactate were measured before and after a graded treadmill walk at baseline and after the 12-week exercise programme. Maximum walking distance (MWD) during the treadmill walk was measured at baseline and 12 weeks. Exercise compliance, functional parameters, and quality of life (VascuQoL) were assessed by questionnaire. Results: MWD, Leg BF, and VascuQoL scores increased significantly, while resting HR, exercise HR, and end of walk rate-pressure-product (RPP) decreased significantly after 12 weeks. Exercise compliance was significantly correlated with increase in MWD (r = 0.89, p < 0.001) and QOL score improvement (r = 0.61, p < 0.001). Conclusions: This supported but unsupervised exercise programme generated improvements in walking distance and leg blood flow without detectable increases in cardiorespiratory work. Exercise compliance is related to MWD and VascuQoL score in a dose-response manner. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.