The mechanisms by which supervised physical training improves walking ability in patients with intermittent claudication (IC) are microcirculatory, rheological, and metabolic. The main mechanism of levo-propionylcarnitine (LPC) is metabolic; it increases the walking ability in claudicants, providing an additional energy to the ischemic muscle by an anaplerotic activity. Therefore, the current study was carried out to ascertain whether the combined treatment has a synergistic effect. The results confirm the effectiveness of supervised physical training in patients with IC, and we recommend the use of LPC during the exercise training program, at least in patients with severe claudication. Finally, underlining the similar mechanisms of physical training and LPC treatment, the study suggests that a cycle of LPC infusions could be advised in patients with severe claudication who cannot be included, for various reasons, in an exercise rehabilitation program.
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