Remote Self-Report Assessment of Walking Impairment in Peripheral Artery Disease

In-person walking assessments are time consuming, limiting their clinical use. This study aimed to identify simple questions that best reflected the walking ability of patients with peripheral artery disease.

This was a post-hoc analysis of responses for self-reported mobility and fatigue-based questions, and walking distance from the BIP (Behavioral Intervention by Allied Health Professionals to Promote Physical Activity) trial. Responses to questions that predicted minimum clinically important differences in walking distance (20 m) were identified using generalized linear models. Random forest was used to train the identified questions using baseline data, which were tested for their ability to estimate 6-minute walking distances measured at 4, 12 and 24 months. Longitudinal associations between responses to questions and walking distance over 24 months were analyzed using linear mixed effects.

In 188 eligible participants, statistical models suggested that different responses to the questions, "Does your health now limit you in climbing 1 flight of stairs?," "Does your health now limit you in walking 100 m?," and "During the past 4 weeks, did you feel worn out?" were predictive of significant differences in walking distance at all follow-up time points (all P<0.05). Linear mixed effects analysis showed that participants who reported "no limitations in walking 100 m" had significantly greater change in walking distance (mean difference, 25.1 m [95% CI, 11.1-39.1]; P<0.001) between baseline and all follow up time points, as compared with those who reported being "limited a lot".

Simple self-report questions reflected walking ability of patients with peripheral artery disease and may be useful for remote assessment.