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Home-Based Exercise and Patient-Reported Outcome Measures in Peripheral Artery Disease: The LITE Randomized Clinical
Mary O Whipple1, Shujun Xu2, Dongxue Zhang2
1School of Nursing, University of Minnesota, Minneapolis, Minnesota.
The American Journal of Cardiology
|February 28, 2025
Summary
High-intensity walking exercise significantly improved walking ability and patient-reported outcomes in peripheral artery disease (PAD) patients compared to low-intensity or no exercise. High-intensity exercise increased the likelihood of meaningful improvements in PAD symptoms.
Area of Science:
- Cardiovascular Medicine
- Exercise Physiology
- Rehabilitation Science
Background:
- Peripheral artery disease (PAD) significantly impacts patient mobility and quality of life.
- Current exercise guidelines for PAD often recommend low-intensity or comfortable-paced walking.
- The optimal exercise intensity for achieving meaningful clinical benefits in PAD remains under investigation.
Purpose of the Study:
- To compare the effects of high-intensity (ischemia-inducing) versus low-intensity (comfortable pace) walking exercise on patient-reported outcomes (PROMs) and objective walking ability in PAD patients.
- To evaluate the attainment of minimal clinically important differences (MCID) for key outcome measures.
Main Methods:
- A randomized controlled trial involving 240 PAD participants comparing 12 months of high-intensity walking, low-intensity walking, and a non-exercise control group.
- Objective walking ability was assessed using the 6-minute walk test (6MWT).
- Patient-reported outcomes included the Walking Impairment Questionnaire (WIQ) distance and speed scores.
Main Results:
- High-intensity exercise significantly improved 6MWT distance compared to both low-intensity exercise and the control group.
- High-intensity exercise significantly increased the odds of achieving MCID for the 6MWT compared to both other groups.
- High-intensity exercise also significantly increased the odds of achieving MCID for WIQ distance and speed scores compared to the control group.
Conclusions:
- High-intensity walking exercise demonstrates superior benefits for objective walking ability in PAD patients compared to low-intensity exercise and non-exercise controls.
- While high-intensity exercise improved PROMs compared to control, it did not show a significant advantage over low-intensity exercise for these specific measures.
- These findings suggest that higher intensity exercise may be a valuable therapeutic strategy for improving functional capacity in individuals with PAD.
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