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Don't stop walking: the in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic.

Internal and emergency medicine
August 1, 2021
Nicola Lamberti et al. (7 authors)
Journal ArticleObservational StudyHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine whether a structured in-home walking program maintained mobility and improved outcomes in peripheral artery disease (PAD) patients during COVID-19 lockdowns.

Results Summary

The study found that the walking program was adhered to safely, with improved pain-free walking distance (PFWD) and stable 6-minute walking distance (6MWD). New-entry subjects showed significant improvements in both measures, while previously enrolled subjects maintained stability, alongside decreased body weight and stable blood pressure and ankle-brachial index.

Population

83 PAD patients (age 72 ± 11, 65 males) enrolled in a walking program before COVID-19 lockdown.

Effective Dosage

Two daily 8-minute sessions of slow intermittent in-home walking.

Duration

9 months pre-lockdown, with follow-up measurements 117 ± 23 days post-lockdown.

Interactions

None mentioned

Extracted Claims (12)
InterventionDirectionEndpointPopulationDosageImpactClaim #
structured in-home walking program
no change
6-minute walking distance (6MWD)
peripheral artery disease (PAD) patients
-
was stable
#1
structured in-home walking program
increase
pain-free walking distance (PFWD)
peripheral artery disease (PAD) patients
-
improved
#2
structured in-home walking program
increase
6-minute walking distance (6MWD)
new-entry subjects (≤ 3 months)
-
obtained significant improvements
#3
structured in-home walking program
increase
pain-free walking distance (PFWD)
new-entry subjects (≤ 3 months)
-
obtained significant improvements
#4
structured in-home walking program
no change
6-minute walking distance (6MWD)
previously enrolled subjects (> 3 months)
-
were stable
#5
structured in-home walking program
no change
pain-free walking distance (PFWD)
previously enrolled subjects (> 3 months)
-
were stable
#6
structured in-home walking program
decrease
body weight (BW)
peripheral artery disease (PAD) patients
-
Decreased
#7
structured in-home walking program
no change
blood pressure (BP)
peripheral artery disease (PAD) patients
-
stable
#8
structured in-home walking program
no change
ankle-brachial index (ABI)
peripheral artery disease (PAD) patients
-
stable
#9
structured in-home walking program
neutral
program adherence
peripheral artery disease (PAD) patients
-
was adhered to by patients
#10
structured in-home walking program
increase
mobility
peripheral artery disease (PAD) patients
-
favored mobility
#11
structured in-home walking program
increase
risk factor control
peripheral artery disease (PAD) patients
-
favored risk factor control
#12
Abstract

We studied the outcomes of peripheral artery disease (PAD) patients enrolled in a structured in-home walking program right before the lockdown due to the SARS-CoV-2 epidemic emergency, to determine whether this intervention ensured the maintenance of mobility even in the case of movement restrictions.We selectively studied 83 patients (age 72 ± 11, males n = 65) enrolled in the program within 9-month before the lockdown. The usual intervention was based on two daily 8-min sessions of slow intermittent in-home walking prescribed in circa-monthly hospital visits. During the lockdown, the program was updated by phone. Six-minute (6MWD) and pain-free walking distance (PFWD) were measured pre- and post-lockdown as well as body weight (BW), blood pressure (BP), and ankle-brachial index (ABI). Sixty-six patients were measured 117 ± 23 days after their previous visit. A safe, pain-free execution of the prescribed sessions was reported (median distance: 74 km). Overall, the 6MWD was stable, while PFWD improved (p < 0.001). The improvement was not related to age/gender, comorbidities, type of home but to the time of enrollment before lockdown. The new-entry subjects (≤ 3 months; n = 35) obtained significant improvements post-lockdown for 6MWD and PFWD, while those previously enrolled (> 3 months; n = 31) were stable. Decreased BW with stable BP and ABI values were also recorded, with better outcomes for new-entry subjects. In PAD patients, a structured walking program performed inside home and purposely guided by phone was adhered to by patients and favored mobility and risk factor control during the COVID-19 pandemic, regardless of walking ability, type of home and external conditions.

Medical Subject Headings (MeSH)
AgedAged, 80 and overCOVID-19Chi-Square DistributionExercise TherapyFemaleHome Care ServicesHumansInterviews as TopicMaleMiddle AgedPeripheral Arterial DiseaseRehabilitationStatistics, NonparametricSurveys and QuestionnairesWalking
Study Links
Quality Scores
Safety90
Efficacy85/10
Quality75/10
Citation Metrics
Total Citations14
Citations/Year3.5
Relative Citation Ratio1.53
NIH Percentile65.8%
Research Impact Scores
APT Score0.75
Weight Score2.43
Normalized Score0.85
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