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Exercise Rehabilitation for Peripheral Artery Disease: A REVIEW
Open accessAbstract
Purpose: To summarize evidence regarding exercise therapy for people with lower extremity peripheral artery disease (PAD). Methods: Literature was reviewed regarding optimal strategies for delivering exercise interventions for people with PAD. Randomized trial evidence and recent studies were emphasized. Results: Randomized clinical trial evidence consistently demonstrates that supervised treadmill exercise improves treadmill walking performance in people with PAD. A meta-analysis of 25 randomized trials (1054 participants) concluded that supervised treadmill exercise was associated with 180 m of improvement in maximal treadmill walking distance and 128 m of improvement in pain-free walking distance compared with a control group. Three randomized trials of 493 patients with PAD demonstrated that home-based walking exercise interventions that incorporate behavioral change techniques improve walking ability in patients with PAD. Furthermore, evidence suggests that home-based walking exercise improves the 6-min walk more than supervised treadmill exercise. Upper and lower extremity ergometry also significantly improved walking endurance in PAD. The Centers for Medicare & Medicaid Services recently determined that Medicare would cover 12 wk (36 sessions) of supervised treadmill exercise for patients with PAD. Conclusions: Supervised treadmill exercise and home-based walking exercise each improve walking ability in patients with PAD. The availability of insurance coverage for supervised treadmill exercise for patients with PAD will make supervised treadmill exercise more widely available and accessible. Home-based exercise that incorporates behavioral change technique is an effective alternative for patients unwilling or unable to attend 3 supervised exercise sessions per week.
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“Mit all diesen Maßnahmen können Sie Ihr Leben verlängern, einen Herzinfarkt oder Schlaganfall verhindern, Ihre Beine erhalten und die Lebensqualität erhöhen (.”
BackgroundInfluentialWalking Exercise for Peripheral Artery Disease
McDermott, M. M. (2023) · JAMA Cardiology · doi:10.1001/jamacardio.2022.5443 · Cited by 7
Self-citationNguyen, C., & Marzolini, S. (2023) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000818 · Cited by 6
“3,10,22,23 Therefore, it is concerning that our study revealed that 46% of patients with PAD and 36% of patients with PAD/CAD withdrew from CR prior to even beginning the program.”
BackgroundTakino, K., Hara, Y., Sakui, D., Kawamura, I., Kikuchi, J., Komoda, T., & Koeda, T. (2024) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2024.2319780 · Cited by 6
“Supervised exercises are recommended to enhance the walking ability of patients with PAD who experience IC (McDermott, 2018).”
Best medical treatment in patients with PAD
Rosenberg, Y., & Behrendt, C. (2023) · VASA · doi:10.1024/0301-1526/a001076 · Cited by 6
Huang, Q., & Wang, F. (2022) · Applied Bionics and Biomechanics · doi:10.1155/2022/3347166 · Cited by 6
“There are many control methods to achieve this, commonly used are PID control, feedforward plus PD control, and calculation torque method [25].”
MethodRetractedSex Differences in Effectiveness of Semaglutide in Patients With Peripheral Artery Disease
Verma, S., Catarig, A., Houlind, K. C., Ludvik, B. H., Nordanstig, J., Rasouli, N., Sourij, H., Thomas, S., Nørgaard, S. K., & Bonaca, M. P. (2025) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2025.08.046 · Cited by 5
Microvascular Function and Ambulatory Capacity in Peripheral Artery Disease
Sullivan, A. E., Behroozian, A. A., Coolbaugh, C. L., Shardelow, E., Smith, E. K., Wells, Q. S., Clair, D. G., Aday, A. W., Garrard, C. L., Curci, J. A., et al. (2025) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.125.015582 · Cited by 5
Gardner, A. W., Montgomery, P. S., Wang, M., & Shen, B. (2021) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000606 · Cited by 5
Physical function and physical activity in hemodialysis patients with peripheral artery disease
Harada, M., Suzuki, Y., Matsuzawa, R., Watanabe, T., Yamamoto, S., Imamura, K., Yoshikoshi, S., Aoyama, N., Osada, S., Yoshida, A., et al. (2022) · Hemodialysis International · doi:10.1111/hdi.13036 · Cited by 5
Considerations for Small Animal Physical Rehabilitation
Greising, S. M., Basten, A. M., Schifino, A. G., & Call, J. A. (2022) · Physiology in health and disease · doi:10.1007/978-3-030-95884-8_2 · Cited by 5
Leslie, R., May, S., Scordis, C., Isgar, V., Poulton, P., & Garnham, A. (2022) · Journal of Vascular Nursing · doi:10.1016/j.jvn.2022.09.006 · Cited by 5
Diet and exercise in relation to lower extremity artery disease
Blinc, A., Paraskevas, K. I., Stanek, A., Jawień, A., Antignani, P. L., Mansilha, A., Mikhailidis, D. P., & Poredoš, P. (2024) · International Angiology · doi:10.23736/s0392-9590.24.05310-0 · Cited by 4
Diseases of the circulatory system as a cause of repeated disability of the adult population
Lyalina, I. V., Puzin, S. N., Арсеньевна, Ш. М., & Сеитягьяевич, М. С. (2022) · Medical and Social Expert Evaluation and Rehabilitation · doi:10.17816/mser84455 · Cited by 4
Nascimento, I. D. O., Geisel, P. P., de Faria, V. C., Ferreira, A. P., Passos, B. R., Prado, D. P., Parreira, V. F., & Pereira, D. A. G. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-080071 · Cited by 4
Management of Pain in People Living With Chronic Limb Threatening Ischemia
Woo, K. Y., Murphy, C., Gregg, E., Moralejo, J., LeBlanc, K. A., & Brandys, T. (2024) · Journal of Wound Ostomy and Continence Nursing · doi:10.1097/won.0000000000001112 · Cited by 3
“31 Walking programs are recommended for claudication as first-line therapy.”
Siercke, M., Berg, S. K., & Missel, M. (2021) · Journal of Vascular Nursing · doi:10.1016/j.jvn.2021.06.001 · Cited by 3
Lavier, J., Bouzourène, K., Millet, G. P., Mazzolai, L., & Pellegrin, M. (2023) · Metabolites · doi:10.3390/metabo13040562 · Cited by 3
“Each session includes a minimum of 30 min of exer ise nd requires patients to walk to maximum ischemic pain [12,22].”
BackgroundMethodRole of the Ankle Brachial Index
McDermott, M. M. (2019) · Springer eBooks · doi:10.1007/978-3-030-24596-2_2 · Cited by 3
Self-citationAddison, O. R., Yang, R., & Serra, M. (2018) · Nutrition and Health · doi:10.1177/0260106018817190 · Cited by 4
“Together, with the plethora of data supporting exercise as beneficial to individuals with PAD (McDermott, 2018), these findings indicate that more research is needed to determine ways to best incorporate pain-free physical activity into the lives of PAD patients, especially in those for whom weight loss is indicated.”
Terada, T., Hausen, M., Mir, H. R., Reed, J. L., & Coutinho, T. A. (2024) · CJC Open · doi:10.1016/j.cjco.2024.09.017 · Cited by 2
Demi̇rel, A., Ahıskalı, G. N., Yamikan, H., & Çalık, E. (2026) · European Journal of Cardiovascular Nursing · doi:10.1093/eurjcn/zvag037 · Cited by 2
Historical Perspectives of Regenerative Rehabilitation: Recovering and Restoring Functional Capacity
Raymond‐Pope, C. J., Hoffman, D. B., Saunders, D., & Greising, S. M. (2022) · Physiology in health and disease · doi:10.1007/978-3-030-95884-8_1 · Cited by 2
Suzuki, K., Kamo, T., Momosaki, R., Kimura, A., Koike, T., Watanabe, S., & Kondo, T. (2023) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2023.101768 · Cited by 2
Waseem, N., Ihtasham, A., Tariq, W., Khan, D. Z., Shafiq, S. S., Ubaid, B., Khan, I., Nadeem, M. A., Aamir, Z., Nouman, Z., et al. (2025) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2025.09.049 · Cited by 1
The Necessity for Renal Rehabilitation
Whalen, S. K., King, A. C., Wilund, K. R., Germain, M. J., & Headley, S. (2020) · Journal of Clinical Exercise Physiology · doi:10.31189/2165-6193-9.3.118 · Cited by 1
Pearson, S. J., Sindall, P., Caldow, E., & TABERNER, P. (2022) · International Angiology · doi:10.23736/s0392-9590.22.04922-7 · Cited by 1
Anderson, C. P., Pipinos, I. I., Johanning, J. M., Myers, S. A., & Rahman, H. (2024) · Bioengineering · doi:10.3390/bioengineering11111103 · Cited by 1
Geisel, P. P., Nascimento, I. D. O., Machado, M. M. G., dos Santos, R. L. G. M., Gomes, B. R. N., Przybysz, G. M. P., Pereira, I. D. F. M., & Pereira, D. A. G. (2025) · Scientific Reports · doi:10.1038/s41598-024-84662-z · Cited by 1
Management of claudication in older adults and the role of exercise therapy
Aalami, O., & Corriere, M. A. (2025) · Seminars in Vascular Surgery · doi:10.1053/j.semvascsurg.2025.07.005 · Cited by 1
Kaminsky, L. (2020) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000567 · Cited by 1
Exercise Interventions in Patients with Diabetes and Peripheral Artery Disease
McDermott, M. M. (2019) · Springer eBooks · doi:10.1007/978-3-030-04816-7_13
Self-citationIntegrating Science, Practice, and Mentorship in Cardiac Rehabilitation
Arena, R. A., Rouleau, C. R., Campbell, T. S., Aggarwal, S., Hauer, T., Wilton, S. B., Stone, J. A., Laddu, D., Ozemek, C., Williamson, T. M., et al. (2019) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000470
Peripheral Artery Disease: An Overview
McDermott, M. M. (2019) · Springer eBooks · doi:10.1007/978-3-030-25249-6_7
Self-citationA mozgásprogram szerepe a kardiológiai rehabilitációban
Kohut, L. (2019) · Honvédorvos · doi:10.29068/ho.2019.3-4.23-28
de Souza, P., & Perfete, C. (2021) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20210595
Xu, Y. (2021) · Ferroelectrics · doi:10.1080/00150193.2021.1906119
“Isometric muscle strength training can increase static muscle strength by 10 before and after the training angle [12,13].”
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Multimorbidity challenges physical activity
Dörenkamp, S. (2016) · doi:10.26481/dis.20160915sd
Primärtherapie der Claudicatio intermittens – Anspruch und Wirklichkeit
Süss, J. D., & Gawenda, M. (2022) · Zentralblatt für Chirurgie - Zeitschrift für Allgemeine Viszeral- Thorax- und Gefäßchirurgie · doi:10.1055/a-1798-0602
Exercise Rehabilitation for Peripheral Artery Disease: A Review: Erratum
(2018) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000381
Najafi, B., & Kang, G. E. (2023) · Elsevier eBooks · doi:10.1016/b978-0-12-815449-6.00025-1
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Medizinische Rehabilitation bei Gefäßerkrankungen
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“While emerging evidence suggests that such multimodal strategies may have a favorable impact on functional capacity and clinical outcomes (10, 33), the current body of literature remains limited and heterogeneous.”
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“Studies of upper-extremity exercise have shown that, despite the exercise load being mainly applied to the upper limbs, remote lower-limb vascular beds may exhibit improved endothelial-dependent vasodilation and microvascular function (47).”
Metadata
- Authors
- McDermott, M. M.
- Affiliations
- Northwestern University (US)
- Corresponding author
- McDermott, Mary M.
- ORCID
- McDermott, Mary M.
- Venue
- Journal of Cardiopulmonary Rehabilitation and Prevention
- Published
- 2018-03
- Volume
- 38
- Issue
- 2
- Pages
- 63-69
- ISSN
- 1932-7501 (ISSN-L)
- PMC
- PMC5831500
- OpenAlex
- W2792589975
- Semantic Scholar
- d06b753d9e115975c1de78b48456fefc1e4257e1
- Cited by
- 91
- References
- 56
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 9 · 2023: 10 · 2022: 15 · 2021: 13 · 2020: 12 · 2019: 8 · 2018: 4
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Cardiopulmonary Rehabilitation and Prevention (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL126117, R01HL122846)
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- peripheral arterial disease, exercise therapy, behaviour change techniques, walking endurance, treadmill walking distance, ergometry, Medicare coverage, lower extremity
- MeSH terms
- Exercise Therapy, Humans, Randomized Controlled Trials as Topic, Walking, Peripheral Arterial Disease
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