Physical activity plays a key role in improving functional capacity and cardiovascular function in peripheral arterial disease (PAD). There is a direct relationship between the improvement in peak oxygen consumption (VO₂peak) and the reduction in the risk of mortality; in addition, improving symptoms related to intermittent claudication provides a better quality of life (QoL).^, However, the assessment of the level of physical activity is often carried out in transversal studies, showing that a higher level of physical activity is correlated with a greater functional capacity, for example. However, the studies do not consider exposure over a given period, leaving open whether there are changes in cardiovascular risk parameters and physical activity levels in these individuals after a follow-up. This is what Cucato et al., analyzed in this edition of the Arquivos Brasileiros de Cardiologia.

Initially, we will bring the methodological study issues, which began in 2015 and included, in the first phase, 268 patients. After 2 years of follow-up, 72 patients were reassessed in the second phase. Different cardiovascular risk parameters and physical activity levels were evaluated using a GT3X+ triaxial accelerometer (Actigraph, Pensacola, FL, USA). Here it is important to highlight the first positive point, which was to use an accelerometer to control physical activity levels, since many studies use a questionnaire to control the level of physical activity. All patients were instructed to use the accelerometer for 7 consecutive days, removing it only to sleep or shower. The device was fixed to the right side of the hip, and for analysis, a minimum of 10 hours of daily physical activity recording was required. Those who had at least 4 days of activity, 3 weekdays and 1 weekend day were considered valid. We highly value this part, as it is a simple method that provides us with extremely high-quality information.

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