A Three Month Home Exercise Programme Augmented with Nordic Poles for Patients with Intermittent Claudication Enhances Quality of Life and Continues to Improve Walking Distance and Compliance After One Year.
Study Goal
The researchers aimed to evaluate the long-term effects of a 12-week augmented home exercise program (using Nordic pole walking) on walking distance, speed, compliance, cost, quality of life, and ankle brachial pressure indices (ABPIs) in patients with intermittent claudication.
Results Summary
Both the augmented and control groups improved walking distance and speed over a year, with the augmented group showing significantly greater improvements (17.5 km vs. 5.6 km). Quality of life and ABPIs improved significantly after 12 weeks, with high compliance (98% in the augmented group).
Population
Patients with intermittent claudication.
Effective Dosage
Not specified (home exercise program augmented with Nordic pole walking).
Duration
12 weeks (with follow-up at 6 and 12 months).
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
home exercise programme augmented with Nordic pole walking | increase | walking distance | patients with intermittent claudication | - | continued to improve | #1 |
home exercise programme augmented with Nordic pole walking | increase | walking speed | patients with intermittent claudication | - | continued to improve | #2 |
home exercise programme augmented with Nordic pole walking | increase | compliance | patients with intermittent claudication | 98% | excellent | #3 |
home exercise programme augmented with Nordic pole walking | increase | mean walking distance | patients with intermittent claudication | 17.5 km | increased | #4 |
home exercise programme augmented with Nordic pole walking | increase | mean walking speed | patients with intermittent claudication | 4.2 km/hour | increased | #5 |
normal walking (control) | increase | mean walking distance | patients with intermittent claudication | from 4.2 km to 5.6 km | increased | #6 |
normal walking (control) | increase | mean walking speed | patients with intermittent claudication | 3.3 km/hour | increased | #7 |
normal walking (control) | increase | compliance | patients with intermittent claudication | 74% | good | #8 |
augmented home exercise programme | increase | resting ankle brachial pressure indices (ABPIs) | patients with intermittent claudication | from mean ± SD 0.75 ± 0.12 to mean ± SD 0.85 ± 0.12 | statistically significant increase | #9 |
augmented home exercise programme | increase | walking improvement parameters | patients with intermittent claudication | - | improved significantly | #10 |
augmented home exercise programme | increase | quality of life parameters | patients with intermittent claudication | - | improved significantly | #11 |
augmented home exercise programme | increase | mean health scores | patients with intermittent claudication | by 79% | improved | #12 |
OBJECTIVE/BACKGROUND: The objective of this study was to collect 1 year follow-up information on walking distance, speed, compliance, and cost in patients with intermittent claudication who took part in a previously reported 12 week randomised clinical trial of a home exercise programme augmented with Nordic pole walking versus controls who walked normally. A second objective was to look at quality of life and ankle brachial pressure indices (ABPIs) after a 12 week augmented home exercise programme. METHODS: Thirty-two of the 38 patients who completed the original trial were followed-up after 6 and 12 months. Frequency, duration, speed, and distance of walking were recorded using diaries and pedometers. A new observational cohort of 29 patients was recruited to the same augmented home exercise programme. ABPIs, walking improvement, and quality of life questionnaire were recorded at baseline and 12 weeks (end of the programme). RESULTS: Both groups in the follow-up study continued to improve their walking distance and speed over the following year. Compliance was excellent: 98% of the augmented group were still walking with poles at both 6 and 12 months, while 74% of the control group were still walking at the same point. The augmented group increased their mean walking distance to 17.5 km by 12 months, with a mean speed of 4.2 km/hour. The control group only increased their mean walking distance from 4.2 km to 5.6 km, and speed to 3.3 km/hour. Repeated ANOVA showed the results to be highly significant (p = .002). The 21/29 patients who completed the observational study showed a statistically significant increase in resting ABPIs from baseline (mean ± SD 0.75 ± 0.12) to week 12 (mean ± SD 0.85 ± 0.12) (t = (20) -8.89, p = .000 [two-tailed]). All their walking improvement and quality of life parameters improved significantly (p = .002 or less in the six categories) over the same period and their mean health scores improved by 79%. CONCLUSIONS: Following a 12 week augmented home exercise programme, most patients with intermittent claudication continued to significantly improve their walking distance and walking speed at 1 year compared with normal walking. Quality of life and ABPIs improved significantly after only 12 weeks and it is postulated that the improvement in ABPI was due to collateral development. These results justify the belief that an augmented home exercise programme will be as clinically effective as existing supervised exercise programmes, with the added benefits of lower cost and better compliance. Funding for a multicentre trial comparing an augmented home exercise programme with existing supervised exercise programme is now urgently required.