Treatment efficacy of intermittent claudication by invasive therapy, supervised physical exercise training compared to no treatment in unselected randomised patients II: One-year results of health-related quality of life

Objective: to compare the effectiveness of invasive therapy, supervised phy sical training and no treatment in terms Of health-related quality of life (HRQL) in patients with intermittent claudication (IC). Design. a prospective, randomised, controlled study. Materials: a total of 253 unselected patients with stable IC were sequentia lly randomised into 3 balanced treatment groups. At I year follow-up data f rom a battery of generic and disease specific HRQL questionnaires, and glob al indices of quality of life and physical condition were available in 171 patients. Results: compared with a non-diseased reference group, clandicants were sub stantially limited in daily physical functioning, but little affected regar ding emotional, cognitive and social functioning, or well-being. Invasive t herapy yielded significantly greater improvements in some aspects of physic al functioning and walk-related symptoms than training. Training was not su perior to invasive therapy on any HRQL dimension and superior to no treatme nt on only one dimension. Treatment effects, however, were generally small- to-moderate and levels of physical dysfunction in all groups remained highe r than reference values. Conclusions. invasive therapy is more effective than supervised training in alleviating illness-specific symptoms and improving certain aspects of phy sical functioning, - the primary HRQL domains impacted on by IC and the pri ncipal goals of its treatment. However, since treatment effect sizes were a t most moderate and given that untreated claudicants reported at most small deterioration in HRQL, the level of evidence supporting, invasive therapy is modest.