Toe systolic pressure improves after supervised exercise therapy in peripheral artery disease: Hemodynamic evidence of distal perfusion change

Objective Supervised Exercise Therapy (SET) improves walking distance in Peripheral Artery Disease (PAD), but its hemodynamic effects are less well defined. Toe pressure, unlike the ankle-brachial index (ABI), remains reliable in calcified or diabetic arteries and may reflect favourable hemodynamic adaptation in the distal circulation. This study evaluated toe pressure as an objective marker of vascular response following SET in patients receiving best medical therapy. Methods This prospective observational study included patients with PAD and intermittent claudication enrolled in a supervised exercise program at a single vascular centre. Eligibility required baseline toe pressure