Many Americans have heart and related circulatory health issues that affect their quality of life. Peripheral artery disease (PAD) currently affects eight million Americans and becomes more prevalent as people age. The disease's symptoms occur when the blood vessels in the legs narrow, causing extreme pain. The restricted blood flow affects the patient's brain, limbs, and other organs.

There are two major forms of treatment for PAD: the first is to manage symptoms of pain so that the individual can resume normal activities, which the second is to cease the progression of other arteries becoming clogged the way the peripheral arteries have. Many medications exist to reduce blood pressure and the progression of artery narrowing, or atherosclerosis. However, methods to rehabilitate PAD patient's limbs have long been debated.

Often, PAD patients will be prescribed a supervised treadmill walking therapy to improve the use of body parts that are most affected by PAD. However, walking therapies are often not covered by insurance companies, and are sometimes inaccessible to patients, as they cannot get to the rehabilitation centers by themselves.

A new study indicates that the home walking therapies offered to PAD patients are vital to their resumption of a normal life and the use of their limbs. The study included 194 PAD patients who were unable to walk without assistance or at all for at least 50 feet. The study's duration of six months seemed to yield great results.

The patients were divided into two groups: one group received a home-based and group-mediated walking intervention, which included walking on an indoor track five times a week for 45 minutes after a 45-minute discussion of exercise techniques with the personal supervisor of their walking therapy. This group was also instructed to walk on their own, or in their homes, at least five days per week for up to 50 minutes, even if they experienced pain. This group also received 90 minutes of coaching once a week about the benefits of relearning how to walk and of the exercises they were doing. The other group was the control — they received no walking therapy treatment or instructions, but did receive separate 60-minute long coaching sessions where health care professionals spoke to them about various diseases and ailments.

Each group was challenged to a six-minute walk test. The test was done before treatments were administered and after the six-month treatment period. The test included walking, unassisted, down a hallway for six minutes — distances traveled were measured. The test was used to predict mobility, improvements in walking, and how much they had learned from both the coaching sessions as well as the therapy itself. The group receiving treatment walked significantly more meters in six minutes than the control group: specifically, they walked 54 meters further than the control group after six months of treatment. Treadmill walking performance was also tested: neither group showed meaningfully improved performance here.

Similarly, when researchers looked at the medications patients were using, patients on pain management medications had a 25-percent improvement in walking performance. Few adverse outcomes occurred as a result of the walking therapy; two people died of heart disease-related issues, but this was not tied to their treatment.

The results of this study indicate the importance of walking therapy to PAD patients. Participants in the study receiving the walking treatment were three times more likely to achieve a small improvement and six times more likely to see a great improvement in their walking ability. The researchers would advise clinicians to start recommending a home-based walking program, along with a coaching session, for PAD patients who do not wish to attend traditional supervised exercise programs.

Source: McDermott MM, Liu K, Guralnik JM, et al. Home-Based Walking Exercise Intervention in Peripheral Artery Disease: A Randomized Trial. JAMA. 2013.

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