Exercise therapy for intermittent claudication: A review of the quality of randomised clinical trials and evaluation of predictive factors

Objective: To Establish the effect of exercise therapy in patients with intermittent claudication and to identify outcome predictors for exercise training. Design: A methodological study of randomised clinical trials. Methods: A quality assessment of all eligible studies was performed, using a list of methodological criteria. A weighing scale for the criteria was developed, based on four main categories: study population, intervention, outcome variables and data presentation/analysis. Results: Ten studies were included in the analysis. Seven randomised clinical trials had a methodological score of 60 or more points (maximum 100), and were considered to be of good quality. The mean of the methodological score was 62.5 (S.D. 8.5). Improvement in pain-free/maximum walking distance/time ranged from 28-210% ((x) over bar 105, S.D. 55.8). Only one study evaluated outcome predictors for exercise therapy. Conclusions: All studies reported a positive effect of exercise therapy on walking distance in patients with intermittent claudication, but no predictive factors were clearly identified. Future research efforts should focus on improving the quality of clinical research for patients with intermittent claudication and developing optimal rehabilitation programs.