Patients with atherosclerotic peripheral arterial disease (PAD) of the lower extremities have
impaired walking ability due to exercise-induced muscle ischemia and the resultant pain of
intermittent claudication. To evaluate the benefit of exercise training as a treatment for patients
with PAD, as well as possible mechanisms associated with improvement, we randomly assigned
19 men with disabling claudication to treated and control groups. Treatment consisted of
supervised treadmill walking (1 hr/day, 3 days/wk, for 12 weeks) with progressive increases in
speed and grade as tolerated. Graded treadmill testing was performed to maximal toleration of
claudication pain on entry and after 12 weeks of training to define changes in peak exercise
performance. After 12 weeks, treated subjects had increased their peak walking time 123%,
peak oxygen consumption 30%, and pain-free walking time 165% (all p