Effects of physical training in intermittent claudication

Mechanisms for increased claudication distance following physical training were studied in ten patients with peripheral arterial insufficiency. The exercise capacity on a bicycle ergometer increased by an average of 26% after 3-4 months of training (P < 0.05). Neither maximum lower leg blood flow during the exercise test nor oxygen uptake at exhaustion changed significantly after training (-8% and +5%, respectively), whereas popliteal-venous O2-saturation was lower at exhaustion after the training than before (8.5±3.2 and 11.4± 4.6, respectively, P < 0.05). Anaerobic glycolysis, as evidenced by the lactate release, was also lowered after the training (P < 0.05).In conclusion, the present study shows that the increased exercise capacity following physical training in claudicants is associated with an increased local aerobic working capacity despite a virtually unchanged blood flow. This increased aerobic exercise capacity might partly be explained by an increased O2 extraction in the lower leg during exercise.