Exercise training improves the walking ability and health-related quality of life(HRQOL) in peripheral arterial disease (PAD) with intermittent claudication. However, there is no report about the effects of exercise in PAD patients who had moderate to severe severity. In this study, we evaluated the effect of exercise training on walking ability and HRQOL in patients with moderate to severe peripheral arterial disease.10 patients of moderate to severe severity (5 patients : restenosis after angioplasty or bypass surgery, 5 patients : did not indicate surgical therapies) were performed a 12-week supervised exercise program with treadmill. Pain-free walking distance (PWD) and maximum walking distance (MWD) were assessed as walking ability and HRQOL at baseline and after 3 months. The HRQOL was assessed with the walking impairment questionnaire (WIQ) and 36-item Short-Form (SF-36).Exercise training significantly improved PWD and MWD. In the HRQOL, physical functioning and vitality scores of SF-36 and distance and speed scores of WIQ significantly improved. In the eight SF-36 subscales, role physical and bodily pain scores correlated with PWD after 3 months. Physical functioning score was negatively correlated with MWD after 3 months. In the four WIQ scales, all of the subscale score were correlated with PWD and MWD at baseline. Especially, stair score was correlated with MWD at baseline and after 3 months.Exercise improves the walking ability and HRQOL in the patients with moderate to severe PAD who are unsuitable for revascularization. But all of the four WIQ scales were only correlated at baseline except the stair climbing, so subjective assessment of patients may not correspond to objective walking ability after exercise training.
