Exercise rehabilitation for the patient with intermittent claudication: a highly effective yet underutilized treatment.

Peripheral arterial disease (PAD), when accompanied by claudication, is a disabling disease that affects 12 percent of the population of the United States (US). PAD is associated with increased mortality as well as decreased functional status and quality of life. Smoking cessation and treatment of diabetes are key aspects of risk factor modification for the PAD patient as well as controlling other cardiovascular risk factors. Typically, only the most severely diseased patients with PAD receive surgery for the indication of claudication and other therapeutic options are being sought. Exciting developments are taking place in the area of drug development for instance. The benefits of a supervised walking exercise program have been consistently demonstrated in persons with PAD and therefore, exercise rehabilitation constitutes an important form of therapy for these persons. Unfortunately, in the US, exercise rehabilitation is not always reimbursed which may lessen its utility presently. All therapies which are used to treat claudication should incorporate measures of functional status and quality of life in addition to treadmill walking in order to ascertain the benefit of a given treatment for patients with PAD.