Walking at home better than hospital-based exercise for peripheral artery disease

New study shows that weekly group support for home-based walking exercise programs is beneficial for patients with peripheral artery disease.

by John Tyburski

Copyright © Daily Digest News, KPR Media, LLC. All rights reserved.

First published at Daily Digest News on May 26, 2014

According to a recent report published in theJournal of the American Heart Association, home-based walking exercise programs supported by weekly group meetings were more effective in motivating patients with peripheral artery disease to exercise regularly and improve their outcome measures than hospital-based programs that required the patients to travel.

“I was somewhat surprised that we achieved our results of a continued difference between the intervention and control groups because it is very difficult to get patients to adhere to an exercise program long term even when it is supervised, and our program was unsupervised, ” said Dr. Mary McDermott, who led the research.

Peripheral artery disease, or PAD, is a condition in which plaque builds up and partially occludes arteries, particularly arteries in the legs that are the long distances from the heart. The result is poor circulation, but studies show that regular exercise such as walking is beneficial. Patients with PAD are at elevated risk for heart attack and stroke.

An estimated eight to 12 million Americans over the age of 50 have PAD. This translates to approximately one in every 20 people over 50. Risk factors include smoking, diabetes, hypertension, high cholesterol, and history of heart attack or stroke.

Treatment options for PAD are limited and include mediation and surgically implanted stents used to open occluded arteries. Supervised treadmill walking has been shown to improve circulation, transportation to and from the exercise sessions pose significant barriers to PAD patients.

McDermott and colleagues randomly assigned 194 enrolled PAD patients to one of two groups and followed them for 12 months. One group participated in a structured, home-based walking program while the reference group did not exercise. The home-based program group members met weekly for six months and then received monthly follow-up phone calls for the second six months. The reference group met weekly for lectures on health topics for the first six months and received monthly telephone calls to discuss the health topics over the second six months.

The fitness of all participants was assessed at the beginning and end of the year-long study. The home-based program participants outperformed the reference group participants by walking faster and for greater distances. The reference group performed worse at the end of the study than they did at the beginning.

McDermott suggested that forming the habit of walking every day for a set amount of time plus the opportunity to bond with other study participants are the most influential determinants for the success of the home-based program group.