Supervised exercise training (SET) is well documented to decrease symptoms and improve walking capacity, functional performance, and quality of life in patients with chronic symptomatic peripheral artery disease (PAD). Most PAD trials reported outcomes after a short-term training intervention period of three to six months. However, the durability of these improvements over time has been less well studied. Additionally, it remains to be clearly determined whether a sex-based difference exists. The first aim of the study was to investigate whether the improvements in functional performance previously reported following the multimodal supervised exercise training (SET) program were maintained over time in patients with chronic symptomatic PAD. The second aim of the study was to investigate whether a sex-based difference exists.

In this single-arm prospective nonrandomized study, patients with chronic symptomatic PAD (Fontaine stage II) participating in the multimodal SET program were investigated. Functional performance [six-minute walking distance (6MWD), the stair climbing test (SCT), and the short physical performance battery (SPPB)] was assessed before and following SET, as well as at 6 and 12 months after SET completion.

Ninety patients (women: n=30; men: n=60) with chronic symptomatic PAD (ankle-brachial index: 0.78 ± 0.22; mean age: 65.4 ± 10.2 years) were included in the study. The 6MWD (+14%, P≤0.001), SCT performance (+26%, P≤0.001), and SPPB (+11%, P≤0.001) significantly improved after SET. The significant improvements in the 6MWD (6 months: +12%, P≤0.001; 12 months: +12%, P≤0.001), SCT performance (6 months: +20%, P≤0.001; 12 months: +22%, P≤0.001), and SPPB (6 months: +10%, P≤0.001; 12 months: +9%, P≤0.001) were maintained over time. Compared to those before SET, the 6MWD (women: +21%; men: +8%), SCT performance (women: +33%; men: +15%), and SPPB (women: +17%; men: +6%) were significantly improved to a greater extent in women than in men for up to 12 months (Group x time interaction effect: P≤0.05).

Chronic symptomatic patients with PAD maintained the significant improvements observed following the multimodal SET over a 12-month period. Compared with men with PAD, women with PAD benefit from SET to a greater extent. This suggests that women with PAD should be highly recommended to participate in training interventions.