[Methods and results of controlled walking training in patients with peripheral arterial occlusive disease]

To establish the effect of exercise training in patients with PAOD Stage II according to Fontaine, 125 publications between 1966 and 1998 were systematically reviewed. The best results occurred with the following method: duration greater than 30 minutes per session, frequency of at least three sessions per week, intermittent walking to near-maximal pain and program length of greater than six months. A methodological study of six randomized clinical trials was performed. The claudication distance was assessed with a treadmill test at a constant-load of 0.82-1.06 Watt/kg. Improvement in initial/absolute claudication distance (ICD/ACD) ranged from +28% to +213%. The average increase was +150% in ICD, and +200% in ACD. Exercise rehabilitation significantly improved patient's quality-of-life as well. However, the benefit of exercise training however was only moderate (6-32%). Exercise training is a very effective therapeutic measure. However, for further use better guidelines and prospective cost-effectiveness studies including evaluation of rehabilitation programs with regard to improvements in functional capacity, modification of risk factors, long-term compliance, quality-of-life and medical costs incurred are needed.