Effect of a home-based exercise program with wearable activity monitor, telephone coaching on walking endurance for peripheral artery disease

Bottom Line: A home-based exercise program that consisted of a wearable activity monitor and telephone coaching to promote walking by patients with peripheral artery disease didn't improve walking endurance.

Why The Research Is Interesting: Peripheral artery disease (PAD) is a circulatory condition in which narrowed blood vessels reduce blood flow to the limbs and that can cause leg pain when walking. Exercise programs improve walking ability in PAD, but to date only exercise programs that involve visits to the medical center have been effective.

Who and When: 200 patients with PAD enrolled in a randomized clinical trial between 2015 and 2017, with final follow-up at the end of 2017.

What (Study Interventions and Outcomes): 99 patients in the exercise intervention were asked to attend four on-site weekly coaching sessions in the first month followed by eight months of using a wearable activity monitor and telephone coaching, while a usual care group of 101 patients had no on-site, active exercise or coaching sessions (interventions); change in the distance walked in 6 minutes after nine months (outcomes)

How (Study Design): This was a randomized clinical trial (RCT). RCTs allow for the strongest inferences to be made about the true effect of an intervention. However, not all RCT results can be replicated in real-world settings because patient characteristics or other variables may differ from those studied in the RCT.

Authors: Mary M. McDermott, M.D., Northwestern University Feinberg School of Medicine, Chicago, and coauthors

Study Limitations: The results may not be generalizable to participants who didn't meet eligibility criteria or who weren't interested in increasing their exercise activity level. A minimal clinically important difference for the 6-minute walk distance has not been defined specifically for patients with PAD.

For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jama.2018.3275)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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