Home-based walking regimen helps patients with PAD

People with peripheral artery disease who adhered to unsupervised, home-based walking exercise had improved functioning and mobility up to a year after beginning the regimen.

Mary M. McDermott, MD, of Northwestern University’s Feinberg School of Medicine in Chicago, and colleagues published their findings online in the Journal of the American Heart Association on May 20.

The GOALS (Group Oriented Arterial Leg Study) trial included 194 participants who were randomized in a 1:1 ratio to undergo a group-mediated cognitive behavioral intervention or be in the control group. The mean age was 69.7 years in the intervention group and 71.6 years in the control group.

During the first six months, participants in the intervention group met weekly with a facilitator, who asked them to walk for exercise at least five days per week. They also received support and instructions on how to adhere to the exercise routine. Meanwhile, participants in the control group received educational lectures that were not related to exercise.

For the next six months, participants in the intervention group received telephone calls from their facilitator, who encouraged them to walk at least five days per week in a home-based, unsupervised setting. Participants in the control group also received telephone calls, but they discussed the educational lectures instead of the exercise regimen.

Of the 194 participants, 91.8 percent completed the six-month follow-up and 86.6 percent completed the 12-month follow-up.

At six months, 6.3 percent of participants in the exercise group and 26.5 percent in the control group reported mobility loss. At 12 months, 5.2 percent and 18.5 percent of participants, respectively, had mobility loss.

Participants in the intervention group also had improvements in the 4-meter walking velocity at six months and the Short Physical Performance Battery (SPPB) at 12 months. The SPBB consisted of 4-meter walking velocity, repeated chair rises and standing balance.