Supervised exercise versus unsupervised exercise for people with leg pain while walking (intermittent claudication)

Some people experience a type of leg pain in the calf of one or both legs that occurs when walking and is relieved only by rest. This is called intermittent claudication, and it is the main symptom of peripheral arterial disease. Peripheral arterial disease is characterized by a reduced flow of blood in the leg due to hardening of the arteries, or blood vessels. Exercise is considered to be of significant benefit to people with this type of leg pain. People need to walk at least three times a week either by themselves or they can participate in a formal, supervised exercise program that involves walking on a treadmill. This review found that people in a supervised program improved their walking ability more than those following an unsupervised walking program. After three months, the people who followed the supervised, treadmill program could walk 150 meters more than the people who did unsupervised exercise. Before that, they were walking around 300 meters, 200 meters pain free, so this improvement is likely to help with independence. These conclusions are drawn from eight trials in which the participants with intermittent claudication had been assigned to either supervised or unsupervised exercise. Altogether there were 319 participants, ranging in age from 40 to 86 years with a mean age of 67 years. The overall quality of the included trials was good, although each had only a small number of participants. The trials lasted from three to twelve months. Keeping to an exercise program is important because of the decrease in leg pain and the likelihood of improving general physical condition, but it is not yet clear that it also improves compliance or quality of life.