What is the role of exercise in the treatment of peripheral arterial occlusive disease (PAOD)?

Updated: Sep 12, 2019
  • Author: Josefina A Dominguez, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Exercise plays a vital role in the treatment of claudication. Patients with PAOD reduce their daily walking because of the claudication pain they experience and their fear of causing further damage. Unfortunately, this leads to an increasingly sedentary lifestyle that is even more detrimental to their health.

In most patients with claudication, regular walking programs result in substantial improvement (80-234% in controlled studies). A daily walking program of 45-60 minutes is recommended. The patient walks until claudication pain occurs, rests until the pain subsides, and then repeats the cycle.

Although the exact mechanism by which exercise improves walking distance remains unknown, a meta-analysis found that the mechanism is most likely to be multifactorial, including changes in cardiorespiratory physiology, endothelial function, mitochondrial number and activity, and muscle conditioning. [26] Regular exercise is believed to condition muscles so that they work more efficiently (ie, extract more blood) and to increase collateral vessel formation.


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