Peripheral artery disease (PAD) is a progressive atherosclerotic disease that affects textgreater8 million Americans.1 Symptoms of PAD are caused by insufficient arterial blood flow to the lower extremities, which often results in ischemia-induced, debilitating leg discomfort associated with walking. Claudication, which is cramping, aching, or pain in the calves, thighs, or buttocks, is the classic symptom of PAD. Claudication is defined as a reproducible discomfort or fatigue in the muscles of the lower extremity that occurs with exertion and is relieved within 10 minutes of rest.2 Most people with PAD do not have classic claudication symptoms but still have significantly greater functional impairment and decline than people without PAD. This significant physical activity limitation results in functional impairment, mobility loss, and decreased quality of life. Improving functioning and quality of life is a major goal in the treatment of individuals with PAD.3,4 The evidence supporting the efficacy of exercise therapy for patients with PAD dates back to 1966 when 6 months of unsupervised intermittent walking exercise was demonstrated to improve time walked to onset of pain and peak walking time (PWT).5 Over the 50 years since that first report, numerous randomized clinical trials and meta-analyses have added to the body of evidence supporting the efficacy of exercise to improve functioning and quality of life in patients with PAD.