This article is more than 5 years old. Information may no longer be current.
Home-based walking program benefited patients with PAD
A 6-month group-mediated cognitive behavioral intervention to promote home-based walking exercise for patients with peripheral arterial disease was associated with improved walking distance and speed, researchers reported.
Previous research has shown that supervised treadmill exercise improves walking performance in people with PAD, but travel to a medical center can be burdensome and the exercise is not covered by insurance, according to the study background.
Therefore, home-based walking exercise may be necessary for those with PAD, researchers wrote.
Mary McGrae McDermott, MD, and colleagues evaluated whether a 6-month group-mediated cognitive behavioral intervention, consisting of a weekly visit to an exercise facility that incorporated group support and self-regulatory skills, would promote adherence to home-based exercise and lead to improved walking performance.
McDermott, from Northwestern University Feinberg School of Medicine, and colleagues randomly assigned 194 patients with PAD to a weekly group-mediated cognitive behavioral intervention or weekly health education lectures at a medical center for 6 months. For 6 to 12 months, both groups received phone calls related to their previous sessions. PAD was defined as ankle-brachial index ≤0.9 or resting ankle-brachial index between 0.91 and 1 if ankle-brachial index dropped at least 20% after a heel-rise test.
The primary outcome was 6-minute walk distance at 12 months. Secondary outcomes included speed and distance scores from the walking impairment questionnaire at 12 months.
One hundred sixty-eight patients (mean age, 71 years; mean ankle-brachial index, 0.68; 48.8% men; 48.2% black) completed 12 months of follow-up testing.
Patients from the intervention group had a greater increase in 6-minute walk distance from baseline to 12 months compared with those from the control group (intervention group, 355.4 m at baseline and 381.9 m at 12 months; control group, 353.1 m at baseline and 345.6 m at 12 months; mean difference, +34.1 m; 95% CI, 14.6-53.5).
Patients in the intervention group also had a greater increase in walking impairment questionnaire speed score from baseline to 12 months compared with controls (intervention group, 36.1 at baseline and 46.5 at 12 months; control group, 34.9 at baseline and 36.5 at 12 months; mean difference, +8.8; 95% CI, 1.6-16.1).
There was no difference between the groups in change in walking impairment questionnaire distance score from baseline to 12 months (P=.139), according to the researchers.
“Our results should encourage physicians to recommend walking even if their patients do not have access to a supervised-exercise program,” McDermott said in a press release.
Disclosure: The study was funded by grants from the NHLBI. The researchers report no relevant financial disclosures.