The Role of Physical Activity in Lower Extremity Peripheral Artery Disease

Abstract

Peripheral artery disease (PAD) is a common disorder characterised by a reduced blood circulation caused by stenosis or occlusion of peripheral arteries of the limbs, predominantly affecting the lower extremities. This condition is typically related to atherosclerosis, but it might also be caused by vasculitis, fibromuscular dysplasia, or adventitial cystic disease. Although atherosclerotic occlusive disease of the lower extremities has high mortality and morbidity rates, it remains underdiagnosed and undertreated condition. The risk factors of PAD are similar to those for coronary and cerebrovascular disease. The most common symptom of PAD is intermittent claudication, but recent studies show that asymptomatic PAD is several times more common in the population than intermittent claudication. The medical approach to peripheral artery disease is multifaceted and includes smoking cessation, lipid-lowering therapy, antiplatelet therapy, antithrombotic therapy, peripheral vasodilators, blood pressure management, glycemic control and various methods of revascularization. An important, although frequently neglected aspect is an exercise therapy. Walking exercise is first-line therapy for PAD-related walking impairment. Supervised walking exercise and structured home-based walking exercise each not only improve walking ability, but also have other benefits, which we would like to discuss in this review.