Physical training of patients with intermittent claudication: indications, methods, and results

Supervised dynamic physical training for 4 to 6 months as a treatment of intermittent claudication was studied in 148 patients who had clearcut symptoms for more than 6 months. Nineteen patients could not complete the planned training program because of cardiac complications, rapid progress of the disease, intercurrent disease, or social reasons. Before the training was started, walking tolerance and calf blood flow were determined. The intensity of each training session (three times per week) was adjusted to the patient's cardiac tolerance as predicted by the cardiac tolerance test. The walking ability increased in 88% of the patients and the average increase was 234%, while the calf blood flow remained unchanged. After the training period, more than 40% of the patients could walk 1,000 m or more. The increase in walking ability was independent of the location of the atherosclerotic lesion or the presence of diabetes. It is concluded that physical training is a good alternative to reconstructive surgery in the treatment of patients with intermittent claudication. It does not interfere with the surgical possibility if operation becomes necessary in the immediate or later course of the disease.