Exercise in the treatment of claudication: assessment and treatment of functional impairment.

Claudication is an important cause of impaired exercise capacity, which limits a patient's ability to walk and thus to meet the personal, social and occupational demands of daily life. Given that improvement of the walking impairment is the primary goal of treating claudication, exercise performance and functional status of patients with claudication should be measured before and after any intervention. Assessment of functional status in both the laboratory and community settings is important so that the various treatments can be judged as to relative efficacy. Studies have shown that exercise training programs have a clinically important impact on functional capacity in persons with claudication. A meta-analysis showed that pain-free walking time increased 180% and maximal walking time increased 120% in claudicants who participated in an exercise program. Substantial improvements have been found in walking speeds and distances (65% and 44%, respectively), caloric expenditure (31%) and physical functioning (67%).