Improving functional outcomes of elderly, high risk, populations is of enormous public health importance with both high social and economic value. Lower limb ischaemia is a chronic and disabling condition with increasing prevalence among elderly populations and has been shown to be associated with impaired physical function and balance. The aim of this study was to investigate the impact of standard treatment, through angioplasty or exercise therapy, on clinical indicators of lower limb ischaemia, physical function, balance, falls risk and quality of life in patients with lower limb ischaemia.Ankle brachial pressure index (ABPI) does not correlate with markers of physical function, balance and falls risk, whereas walking distances do correlate with physical function and falls. Angioplasty treatment leads to significant improvements in clinical indicators of lower limb ischaemia, markers of physical function that include an element of walking, history of falling or stumbling, fear of falling and quality of life. Balance is only slightly improved by angioplasty at 3 months following treatment. Supervised exercise programme treatment leads to significant improvements in walking distances but not ABPI, and physical function and a history of stumbles are improved. Balance is markedly improved at 3, 6 and 12 months from baseline. Quality of life improvements are seen at 3 and 6 months but not at 12 months from baseline.This study highlights the high frequency of balance abnormalities among claudicants and recognises the link between balance abnormalities and falls risk. Treatment with either angioplasty or exercise improves markers of physical function, balance, falls risk and quality of life but there are differences between the 2 treatment effects. It is important that patients are thoroughly assessed in the wider context of their presentation and that treatment is targeted to the individual
