Home-based walking programmes 'benefit PAD patients'
GPs should recommend home-based walking programmes for patients with peripheral artery disease (PAD) if they do not have access to supervised exercise programmes.
US researchers looked at 194 patients with PAD who participated in a four-year randomised controlled trial. Participants were randomised into one of two groups: an intervention group given a home-based walking programme and group cognitive behavioural therapy, or a group given simple health education (regarded as the control group). The primary outcome was the six-month change in six-minute walk performance, and a secondary outcome of maximum treadmill walking time was also measured.
Participants randomised to the intervention group significantly increased their six-minute walk distance, with a distance of 357.4m pre-study and 399.8m post-study, compared with 353.3m to 342.2m for those in the control group. Maximum treadmill walking time increased from 7.91 pre-study, to 9.44 minutes post-study in the intervention group, and increased from 7.56 to 8.09 minutes in the control group.
What this means for GPs
The researchers noted that the home exercise group showed ‘improved walking performance and physical activity’ and advised that ‘clinical practice guidelines should advise clinicians to recommend home-based walking programmes with a weekly group-mediated cognitive behavioural intervention’ for patients with PAD who do not have access to supervised exercise programmes.
JAMA, Online July 2013