Exercise that Induces Leg Pain Appears To Be Beneficial for Peripheral Artery Disease

Peripheral artery disease (also called peripheral arterial disease) is a common condition in which narrowed arteries reduce blood flow to the arms or legs. In peripheral artery disease (PAD), the legs or arms — usually the legs — don’t receive enough blood flow to keep up with demand. This may cause leg pain when walking (claudication) and other symptoms.

It usually develops due to a buildup of fatty deposits in the arteries, known as atherosclerosis, which decreases the blood flow to the legs, and sometimes, the arms. 

Walking exercise is first-line therapy for people with PAD. However, the symptoms of ischemia are a major barrier to walking exercise in people with the disease. 

In a recently published study, researchers evaluated the use of Low Intensity Exercise Intervention (LITE) in PAD in the treatment of PAD. The research appears in the Journal of the American Heart Association. 


For the study, the team included a total of 264 participants with PAD. The participants were randomized to either perform home-based walking exercise that induced ischemic leg symptoms, home-based walking exercise without inducing leg symptoms, or a non-exercising control group for a total of 12 months.

The 4-meter walking velocity test and Short Physical Performance Battery (SPPB), which consists of 3 components: 4-m walking speed, strength for the chair rise, and balance tests, were used to assess walking speed and standing balance. Lower scores in these tests are associated with higher rates of mobility loss and mortality in people with PAD. 

The team found that those participants who walked for exercise at a comfortable pace without ischemic leg symptoms slowed their walking speed during daily life and worsened the Short Physical Performance Battery score, which could be a potentially harmful effect. 

According to the researchers, their results are consistent with the commonly used phrase: “No pain, no gain.” They are now working to identify interventions that can make higher-intensity exercise easier for people with PAD. 


Michael M. Hammond, et al. Effects of Walking Exercise at a Pace With Versus Without Ischemic Leg Symptoms on Functional Performance Measures in People With Lower Extremity Peripheral Artery Disease: The LITE Randomized Clinical Trial. 2022. JAHA. https://doi.org/10.1161/JAHA.121.025063 

Peripheral artery disease. Mayo Clinic. Retrieved from:

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