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

Vascular medicine (London, England)
August 1, 2015
Ryan J Mays et al. (8 authors)
Journal ArticleRandomized Controlled TrialResearch Support, N.I.H., ExtramuralHuman StudyClinical
Study Details

Study Goal

The researchers aimed 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 patients with peripheral artery disease (PAD).

Results Summary

The intervention did not significantly improve peak walking time (PWT), the primary outcome, but showed improvements in claudication onset time (COT) and patient-reported outcomes via the Walking Impairment Questionnaire (WIQ). The study suggests potential benefits for secondary outcomes but requires further investigation with a larger sample size.

Population

Patients with peripheral artery disease (PAD) who previously received peripheral endovascular therapy or presented with stable claudication (n=25).

Effective Dosage

Not specified

Duration

14 weeks

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Supervised walking exercise
increase
walking ability
patients with peripheral artery disease (PAD)
-
is an effective treatment to improve
#1
community-based walking exercise program with training, monitoring and coaching (TMC) components
no change
peak walking time (PWT)
PAD patients
+2.1 ± 0.7 versus 0.0 ± 0.7 min
did not significantly improve
#2
community-based walking exercise program with training, monitoring and coaching (TMC) components
increase
claudication onset time (COT)
PAD patients
+1.6 ± 0.8 versus -0.6 ± 0.7 min
Changes in COT were greater for intervention patients compared with control patients
#3
community-based walking exercise program with training, monitoring and coaching (TMC) components
increase
Walking Impairment Questionnaire (WIQ) scores
PAD patients
+18.3 ± 4.2 versus -4.6 ± 4.2%
Changes in WIQ scores were greater for intervention patients compared with control patients
#4
walking program with TMC
no change
the primary outcome
PAD patients
-
did not improve
#5
exercise in community settings
increase
Other walking performance and patient self-reported outcomes
-
-
were improved
#6
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.

Medical Subject Headings (MeSH)
AgedColoradoCommunity Health ServicesCounselingExercise TestExercise TherapyExercise ToleranceFeasibility StudiesFemaleHumansIntention to Treat AnalysisIntermittent ClaudicationMaleMiddle AgedPatient CompliancePeripheral Arterial DiseasePilot ProjectsPredictive Value of TestsProgram EvaluationRecovery of FunctionSurveys and QuestionnairesTime FactorsTreatment OutcomeWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality75/10
Citation Metrics
Total Citations42
Citations/Year4.2
Relative Citation Ratio1.88
NIH Percentile72.7%
Research Impact Scores
APT Score0.75
Weight Score1.77
Normalized Score0.61
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