Exercise & Sports Science Australia (ESSA) position statement on exercise prescription for patients with peripheral arterial disease and intermittent claudication

Supervised exercise training is considered the most effective treatment for increasing exercise tolerance in patients with PAD, and is also associated with improvements in daily physical activity and quality of life, and a reduction is cardiovascular disease risk. Exercise should be prescribed and progressed for patients individually, taking into consideration their disease severity, exercise tolerance and relevant comorbidities

While walking programs are beneficial and frequently prescribed, other forms of aerobic exercise such as cycling or arm-cranking may also be incorporated as tolerated by patients. Forty minutes of accumulated aerobic activity,three times per week, is recommended for most patients. Patients should be encouraged to commence exercise at a moderate intensity, and should stop and rest if claudication pain becomes severe.

Resistance training should also be included on at least two days per week with the goal of improving muscular strength and endurance. Comorbidities such as musculoskeletal complaints, hypertension, diabetes and peripheral neuropathy are common in patients with PAD and may exacerbate their functional limitations. Given the high cardiovascular risk associated with PAD, it is important that patients are appropriately monitored during exercise.