Background
Intermittent claudication (IC) is a common condition which is associated with significant
quality of life limitation. National Institute for Health and Care Excellence guidelines
recommend a group-based supervised exercise program as the primary treatment option
for claudication, based on clinical and cost effectiveness. This review aims to assess
the mechanisms by which exercise improves outcomes in patients with IC.
Methods
MEDLINE, EMBASE, and PubMed were searched using the search strategy “claudication”
[AND] “exercise” [AND] “mechanisms.” Searches were limited from 1947 to October 2014.
Only full-text articles published in the English language in adults (over 18 years
of age) were eligible for the review. Any trial involving a nonsupervised exercise
program was excluded. Abstracts identified by the database search were interrogated
for relevance and citations from the shortlisted papers were hand searched for relevant
references.
Results
The search yielded a total of 112 studies, of which 42 were duplicates. Forty-seven
of the remaining 70 were deemed appropriate for inclusion in the review. Exercise
is the first-line treatment for IC. Supervised exercise programs improve walking distances,
endothelial and mitochondrial function, muscle strength, and endurance. Furthermore,
it leads to a generalized improvement in cardiovascular fitness and overall quality
of life.
Conclusions
The mechanism by which exercise improves outcome in claudicants is complicated and
multifactorial. Further research is required in this area to fully elucidate the precise
and predominant mechanisms and to assess whether targeted exercise program modification
maximizes mechanism efficacy and patient outcome.
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Article Info
Publication History
Published online: September 08, 2015
Accepted:
May 25,
2015
Received:
April 1,
2015
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
