Home Walking Exercises for Peripheral Artery Disease Treatment

Walking exercise regimens performed at home have been recommended as a peripheral artery disease treatment, but evidence of their effectiveness is inconsistent. Thus, Linsdsay M. Bearne and colleagues from King’s College London in London, UK, evaluated a peripheral artery disease exercise reported that, “among adults with PAD and intermittent claudication, a home-based, walking exercise behavior change intervention, compared with usual care, resulted in improved walking distance at 3 months.”

Peripheral Artery Disease Treatment Study Design

The clinical trial, published in JAMA, included a total of 190 patients with PAD and intermittent claudication from six hospitals in the UK. The participants were randomized 1:1 to receive either usual care, or “a walking exercise behavior change intervention delivered by physical therapists trained to use a motivational approach.” The primary measure was six-minute walking distance at the three-month follow-up visit compared to baseline (minimal clinically important difference: 8–20 m). Secondary measures included: the Walking Estimated Limitation Calculated by History (WELCH) questionnaire, the Brief Illness Perceptions Questionnaire, and the Theory of Planned Behavior Questionnaire.

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Peripheral Artery Disease Treatment Outcomes

Among the 148 (78%) patients who completed the three-month follow-up, the mean six-minute walking distance in the peripheral artery disease treatment group improved from a baseline of 352.9 m to 380.6 m at three months. Meanwhile, the mean distance in the usual care control group was 369.8 m at baseline and 372.1 m at month three (mean between-group difference = 16.7 m; 95% confidence interval [CI], 4.2–29.2 m; p = 0.009).

Significantly different secondary measures were as follows: WELCH scores increased from 18.0 to 27.8 in the treatment group versus 20.7 to 20.7 in the control group; Brief Illness Perceptions Questionnaire scores changed from 45.7 to 38.9 in the treatment group compared to from 44.0 to 45.8 in the control group; and Theory of Planned Behavior Questionnaire scores went from 14.7 to 15.4 in the treatment group and from 14.6 to 13.9 in the control group.

The authors recorded 13 serious adverse events among patients in the intervention group and three in the usual care group—though they stated that “all were determined to be unrelated or unlikely to be related to the study.”

Conclusions

In closing, the authors supported that a home-based walking exercise appeared to benefit  peripheral artery disease treatment, though they acknowledged that “further research is needed to determine the durability of these findings”

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SOURCEJAMA