Format

Send to

Choose Destination
Vasc Med. 2015 Aug;20(4):339-47. doi: 10.1177/1358863X15572725. Epub 2015 Mar 9.

Community-based walking exercise for peripheral artery disease: An exploratory pilot study.

Author information

1
School of Physical Therapy and Rehabilitation Science, College of Health Professions and Biomedical Sciences, University of Montana, Missoula, MT, USA The International Heart Institute of Montana Foundation, Saint Patrick Hospital, Providence Medical Group, Missoula, MT, USA Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA Center for Women's Health Research, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA Ryan.Mays@mso.umt.edu.
2
Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA CPC Clinical Research, Aurora, CO, USA.
3
Mater Private Heart and Vascular Centre, Dublin, Ireland.
4
Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, CO, USA.
5
Center for Women's Health Research, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
6
Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
7
Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA Center for Women's Health Research, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.

Abstract

Supervised walking exercise is an effective treatment to improve walking ability of patients with peripheral artery disease (PAD), but few exercise programs in community settings have been effective. The aim of this study was to determine the efficacy of a community-based walking exercise program with training, monitoring and coaching (TMC) components to improve exercise performance and patient-reported outcomes in PAD patients. This was a randomized, controlled trial including PAD patients (n=25) who previously received peripheral endovascular therapy or presented with stable claudication. Patients randomized to the intervention group received a comprehensive community-based walking exercise program with elements of TMC over 14 weeks. Patients in the control group did not receive treatment beyond standard advice to walk. The primary outcome in the intent-to-treat (ITT) analyses was peak walking time (PWT) on a graded treadmill. Secondary outcomes included claudication onset time (COT) and patient-reported outcomes assessed via the Walking Impairment Questionnaire (WIQ). Intervention group patients (n=10) did not significantly improve PWT when compared with the control group patients (n=10) (mean ± standard error: +2.1 ± 0.7 versus 0.0 ± 0.7 min, p=0.052). Changes in COT and WIQ scores were greater for intervention patients compared with control patients (COT: +1.6 ± 0.8 versus -0.6 ± 0.7 min, p=0.045; WIQ: +18.3 ± 4.2 versus -4.6 ± 4.2%, p=0.001). This pilot using a walking program with TMC and an ITT analysis did not improve the primary outcome in PAD patients. Other walking performance and patient self-reported outcomes were improved following exercise in community settings. Further study is needed to determine whether this intervention improves outcomes in a trial employing a larger sample size.

KEYWORDS:

activity monitors; claudication; environmental audit; unsupervised exercise

PMID:
25755148
PMCID:
PMC4749131
DOI:
10.1177/1358863X15572725
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center