Background Claudication distance is the commonest measure of the disab
ility caused by lower-limb occlusive arterial disease. The accuracy of
claudication distance as a surrogate for handicap has been assessed.
Methods Seventy patients who attended a specialist vascular clinic wit
h intermittent claudication were studied prospectively. Patients were
asked to estimate their claudication distance and maximum walking dist
ance before undergoing both a patient-controlled corridor walk and a f
ixed-speed treadmill walk. Results The claudication distance reported
by patients bore little relation to the distance recorded in the medic
al correspondence. There was no correlation between the estimated dist
ance and the actual distance walked on either a patient-controlled cor
ridor walk or a fixed-speed treadmill walk. Most patients were able to
walk substantially further at their own speed on the corridor than on
the treadmill at a slower speed. Conclusion Claudication distance is
spuriously estimated, inaccurately reported, falsely recorded, inappro
priately measured and usually misinterpreted. It is of little value in
judging the need for treatment. Objective measures of the handicap ca
used by the disability of reduced walking distance are required if rat
ional management decisions are to be made.