TREATMENT OF INTERMITTENT CLAUDICATION - THE IMPACT ON QUALITY-OF-LIFE

Objectives: To measure changes in claudicant's quality of life after s urgery, angioplasty or unsupervised exercise. To explore the relations hip between clinical indicators of limb perfusion and patient's percep tion of health change. Design: Prospective study. Setting: University Hospital vascular outpatients. Materials and Methods: 202 claudicants referred for Duplex of lower limb arterial disease over a 12 month per iod. The shout form 36 questionnaire was used to determine quality of life. Ankle pressures and walking distances were determined. Main Resu lts: The SF-36 was completed by 186 patients (92%) before and after tr eatment (34 operative patients, 74 angioplasty and 78 treated by exerc ise alone). Baseline quality of life was worse in surgical patients. U nsupervised exercise produced minimal changes in quality of life. Angi oplasty and operation produced similar significant improvements in phy sical functioning and pain. Changes in physical function or pain score s were unrelated to changes in ankle pressure. Conclusions: Unsupervis ed exercise programs are unlikely to significantly improve patient's q uality of life. The benefits of surgery and angioplasty support a rela xation in the indications far investigation and treatment of claudican ts. Patients with impaired perceived health should not be denied treat ment on the basis of preintervention ankle pressure or walking distanc e alone.