A new home-based exercise program has shown significant promise in encouraging people with clogged leg arteries to walk farther, faster. Researchers at Northwestern University Feinberg School of Medicine in Chicago published the first study to reveal the long-term benefits of a home-based walking program, in the Journal of the American Heart Association.
PAD affects an estimated eight million people in the United States, according to the American heart Association. It’s similar to coronary disease in that it is the narrowing of the arteries caused by plaque build up, but those that are most common in the pelvis and legs.
“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, lead author and a physician and professor at Northwestern University in Chicago told Reuters Health.
The study compared patients with symptoms of peripheral artery diseases (PAD) to those without PAD in a six-month walking program that required patients to attend weekly meetings for support and skills training. At the meetings, patients acquired skills to help them adapt to their own home routine exercise program. After six months, patients received phone calls to their homes in order to motivate patients to continue walking seven-to-12 months afterwards.
“Symptoms of peripheral artery disease are often not classic. A patient might just experience weakness in their legs or tiredness and both the doctor and the patient might think that it’s just a part of aging,” McDermott said.
Patients were instructed to try to walk at least five days a week for up to 50 minutes each walk. Walking exercise is the most efficient non-invasive treatment for PAD patients, however programs must take into account that walking may cause cramp-like pain in muscles that don’t get enough oxygen. The at-home program realized the risks and told patients to stop and when they experienced leg pain and wait until they felt comfortable again enough to start walking. The at-home component is in an effort to avoid being discouraged by treatment that requires them to travel to a medical center.
"The results emphasize the importance of recognizing and treating PAD, a common condition that often remains undiagnosed and can become life-threatening as it restricts circulation to the legs, arms, feet, and kidneys," McDermott said. "Patients with PAD are also at heightened risk for heart attack and stroke."
Each participant took a six-minute test before the walking program started and then another test at the end of the study to measure how quickly they were able to pace back and forth along a 100-foot hallway. At the 12-month mark, participants increased their walking distance from 355.4 to 381.9 meters, an 87-foot improvement.
"Don't think walking problems are a normal part of aging. If you have leg pain, weakness, tingling or other difficulty walking, report it to your doctor and ask about the possibility you may have PAD. Diagnosing PAD is important because therapies can improve your health," McDermott said.
Researchers and physicians alike hope that the long-term affects continue to show benefit in patients after the 12-month phone calls of encouragement end, especially considering one in every 20 Americans over the age of 50 is diagnosed with PAD, according to the National Institutes of Health.
“This study is important. This kind of paper gets at the issue of how we provide this kind of long lasting improved performance to patients in a cost effective fashion,” Robert Patterson, a physician and clinical researcher at Brown University, told Reuters Health.
Source: Mcdermott M, Guralnik J, Criqui M, et al. Home‐Based Walking Exercise in Peripheral Artery Disease: 12‐Month Follow‐up of the Goals Randomized Trial. Journal of the American Heart Association. 2014.