EXERCISE THERAPY FOR INTERMITTENT CLAUDICATION - A REVIEW OF THE QUALITY OF RANDOMIZED CLINICAL-TRIALS AND EVALUATION OF PREDICTIVE FACTORS

Objective: To Establish the effect of exercise therapy in patients wit h intermittent claudication and to identify outcome predictors for exe rcise training. Design: A methodological study of randomised clinical trials. Methods: A quality assessment of all eligible studies was perf ormed, using a list of methodological criteria. A weighing scale for t he criteria was developed, based on four main categories: study popula tion, intervention, outcome variables and data presentation/analysis. Results: Ten studies were included in the analysis. Seven randomised c linical trials had a methodological score of 60 or more points (maximu m 100), and were considered to be of good quality. The mean of tile me thodological score was 62.5 (S.D. 8.5). Improvement in pain-free/maxim um walking distance/time ranged from 28-210% ((x) over bar 105, S.D. 5 5.8). Only one study evaluated outcome predictors for exercise therapy . Conclusions: All studies reported a positive effect of exercise ther apy on walking distance in patients with intermittent claudication, bu t no predictive factors were clearly identified. Future research effor ts should focus on improving the quality of clinical research for pati ents with intermittent claudication and developing optimal rehabilitat ion programs.