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Atherosclerosis. 2015 Apr;239(2):599-606. doi: 10.1016/j.atherosclerosis.2015.02.038. Epub 2015 Feb 24.

Upper versus lower limb exercise training in patients with intermittent claudication: a systematic review.

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  • 1MOVE Research Institute Amsterdam, VU-University Amsterdam, van der Boechorststraat 9, NL 1081 BT Amsterdam, The Netherlands.
  • 2Department of Exercise and Sport Science, University of Wisconsin - La Crosse, USA.
  • 3Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain.
  • 4Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain; European University, Madrid, Spain.
  • 52E Science, Via Monte Grappa, 13, I-27038 Robbio (PV), Italy. Electronic address:


Lower extremity (LE) exercise training has been shown to contribute to improvements in Maximum Walking Distance (MWD), Claudication Distance (CD), peak oxygen uptake (VO2peak) and Quality of Life (QoL) in patients with intermittent claudication (IC). However, little is known regarding the efficacy of upper extremity (UE) exercise training in comparison to the widely used LE training. The objective of this systematic literature review is to identify and synthesize the available literature on the effects of UE versus LE exercises using the International Classification of Functioning (ICF) conceptual framework. A total of 6 randomized controlled trials comparing UE to LE exercises were included in this study. Two of the articles were considered to be of high quality using the PEDro grading list. Both UE and LE training groups demonstrated significant improvements in MWD, CD, VO2peak and QoL in comparison to the control group but LE was not better than UE training. This supports the use of UE training as an alternative to LE, which could provide symptomatic relief to patients with IC without the discomfort caused during the LE training.


Claudication distance; Functional capacity; Maximum walking distance; Peripheral arterial disease

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