Effects of physical training in intermittent claudication.

Mechanisms for increased claudication distance following physical training were studied in ten patients with peripheral arterial insufficiency. The exercise capacity on a bicycle ergometer increased by an average of 26% after 3--4 months of training (P less than 0.05). Neither maximum lower leg blood flow during the exercise test nor oxygen uptake at exhaustion changed significantly after training (-8% and +5%, respectively), whereas popliteal-venous O2-saturation was lower at exhaustion after the training than before (8.5 +/- 3.2 and 11.4 +/- 4.6, respectively, P less than 0.05). Anaerobic glycolysis, as evidenced by the lactate release, was also lowered after the training (P less than 0.05). In conclusion, the present study shows that the increased exercise capacity following physical training in claudicants is associated with an increased local aerobic working capacity despite a virtually unchanged blood flow. This increased aerobic exercise capacity might partly be explained by an increased O2 extraction in the lower leg during exercise.