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February 21, 1996

Exercise Rehabilitation for Treatment of Claudication

Author Affiliations

University of Minnesota Medical School—Minneapolis
Brigham and Women's Hospital Harvard Medical School Boston, Mass
University of Colorado Health Sciences Center Denver
Stanford University School of Medicine Stanford, Calif

JAMA. 1996;275(7):519-520. doi:10.1001/jama.1996.03530310025023

To the Editor.  —The meta-analysis by Drs Gardner and Poehlman1 serves a critical role in demonstrating the efficacy of exercise rehabilitation as a therapeutic modality for individuals with claudication. Heretofore, cost studies that have evaluated essentially all therapeutic modalities for claudication (whether exercise, angioplasty, or surgery) have been hampered by small sample size or the lack of a randomized, controlled study design. It should be noted that these past limitations have in part been ameliorated by two significant publications that were not included in the JAMA meta-analysis. A randomized controlled trial performed by Hiatt and colleagues2 demonstrated that a 12-week supervised walking program was superior in improving exercise performance compared with a well-described control group, and further validated the use of a graded exercise treadmill protocol to assess functional limitations in patients with claudication. Another randomized trial performed by Creasy and colleagues3 compared the relative efficacy of