Discussion
This controlled, randomized trial demonstrated
that a 12-week exercise training program for patients
with PAD increased peak exercise performance in all
treated subjects, delayed the onset and progression
of claudication pain during exercise, and improved
community-based walking ability. The improvement
in performance was correlated with a change in
carnitine metabolism (an index of cellular metabolism)
and not to a change in blood flow. In control
subjects, the modest increase in peak walking time
was not associated with changes in peak treadmill
grade or Vo2. As a result, claudication pain severity