Functional evaluation of intermittent claudication

Despite new technologies and therapeutical developments in angiology, the functional evaluation of intermittent claudication still remains unsatisfying. The Fontaine-Classification from 1954, which is currently used as stage IIa and IIb, is not generally accepted. In the clinical routine, the estimate taken for decision strategy, even for the interventional and surgical procedures, is often that claimed by the patient in his case history. Due to lack of standardization the results of therapeutical studies are not comparable. Recommendations for treadmill exercise testing are confusing. Globally, both the constant-load-test at 3 km/h and 12% grade and the graded-exercise-test (3,2 km/h with an increase in grade of 3,5% every 3 minutes) show similar results. However in patients with absolute claudication distance between 50-150 m, the constant-load-test is superior. The problem in measurement of the treadmill walking distance could probably be solved by the quantification of exercise capability and evaluation of physical capacity in patients with intermittent claudication in the same manner as usual in cardiology and sports medicine.