Exercise-Based Cardiac Rehabilitation for Peripheral Artery Disease

Peripheral artery disease (PAD) is a pervasive atherosclerotic condition affecting well over 100 million adults worldwide and associated with major functional limitations, reduced quality of life, and elevated risks of myocardial infarction, stroke, limb events, and mortality. Exercise therapy-preferably supervised or delivered through structured, monitored home-based programs-is a first-line, guideline-endorsed therapy that improves walking performance and patient-reported outcomes and contributes to comprehensive secondary prevention. This review synthesizes mechanistic underpinnings (endothelial, angiogenic, metabolic, and autonomic) and appraises the comparative effectiveness, safety, and implementation models of supervised exercise therapy (SET), structured home-based and hybrid programs, and alternative modalities in PAD. Finally, we summarize policy aspects and persistent gaps to guide clinical practice and future research.