Home-based walking exercise intervention in peripheral artery disease: a randomized clinical trial

Area of Science:

• Cardiovascular Medicine
• Rehabilitation Science
• Behavioral Medicine

Background:

• Clinical guidelines lack evidence for home-based walking programs in peripheral artery disease (PAD).
• Many PAD patients cannot or prefer not to participate in supervised exercise.

Purpose of the Study:

• To evaluate a home-based walking program using group-mediated cognitive behavioral intervention.
• To compare its effectiveness against a health education control group in improving functional performance in PAD patients.

Main Methods:

• A randomized controlled trial involving 194 PAD patients (72.2% without classic claudication symptoms).
• Participants were assigned to either a home-based cognitive behavioral walking intervention or an attention control group.
• The primary outcome was the 6-month change in 6-minute walk performance.

Main Results:

• The intervention group showed significant improvements in 6-minute walk distance, maximal treadmill walking time, and physical activity levels.
• Patient-reported outcomes, including the Walking Impairment Questionnaire (WIQ) distance and speed scores, also significantly improved.
• Mean difference in 6-minute walk distance was 53.5 meters (P < .001).

Conclusions:

• A home-based walking program effectively enhances walking endurance and physical activity in PAD patients.
• The intervention also improves perceived walking endurance and speed, regardless of claudication symptoms.
• This approach provides a valuable alternative for patients unable to access supervised programs.