• Mays R
  • Casserly I
  • Rogers R
  • et al.
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Background: Peripheral artery disease (PAD) is a major cause of walking limitation. Supervised walking exercise is an effective treatment to improve the walking ability of patients, but exercise programs based in community settings have often been ineffective. The aim of this study was to determine the efficacy of a novel community-based walking exercise program with specific training, monitoring and coaching (TMC) components to improve walking exercise performance and patient-reported outcomes in PAD patients. Methods: This study was a randomized, controlled trial including patients with PAD who received either a community-based walking exercise program with elements of TMC or no treatment beyond standard, initial clinical advice to walk. For patients randomized to the intervention group, a comprehensive TMC walking exercise program was implemented over a period of 14 weeks that included: 1) initial supervised walking exercise at the hospital (2 weeks), 2) a walking exercise program in the community (12 weeks), which included an audit of the local walking environment and staff-supervised walking exercise visits in each patient's community setting and 3) weekly patient phone contact, use of activity monitors and patient-completed walking exercise logs. The primary outcome was peak walking time (PWT) on a graded treadmill. Secondary outcomes included claudication onset time (COT) and patient-reported outcomes assessed by the Walking Impairment Questionnaire (WIQ). Results: Nineteen patients completed baseline and end of study assessments. Intervention patients (n = 9) had greater change score improvements compared to control patients (n = 10) for PWT (mean + standard error: +2.3 + 0.7 vs. +0.1 + 0.7 min, p<0.05) and COT (+1.7 + 0.8 vs. -0.6 + 0.7 min, p<0.05). Changes in WIQ scores were also greater for intervention patients compared with the control patients (+19.3 + 4.5 vs. -4.7 + 4.2%, p<0.01). Conclusions: A community-based walking exercise program integrating TMC components improved exercise performance and patient-reported outcomes of PAD patients. Programs of this type may benefit PAD patients by addressing the barriers associated with walking exercise in community settings




Mays, R. J., Casserly, I., Rogers, R., Main, D., Hiatt, W., Kohrt, W., … Regensteiner, J. (2014). COMMUNITY-BASED WALKING EXERCISE FOR PATIENTS WITH PERIPHERAL ARTERY DISEASE: A PILOT STUDY. Journal of the American College of Cardiology, 63(12), A2035.

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