Exercise in Peripheral Arterial Disease

A supervised exercise programme is first-line treatment for intermittent claudication in peripheral arterial disease (PAD): walk into the pain, rest, then walk again.

That advice sounds wrong to patients and often to clinicians, because elsewhere we teach people to work below the pain threshold. In claudication, walking that provokes symptoms is the training stimulus. Supervised exercise is offered to everyone with claudication ahead of drug treatment or revascularisation, and cardiovascular secondary prevention runs alongside it from the outset.