Home-based walking intervention benefits people with diabetes and PAD
MedWire News: A 6-month home-based walking program improves walking speed and quality of life in patients with diabetes and peripheral artery disease (PAD), research shows.
Previous research has shown the benefits of supervised treadmill walking interventions in PAD but this is the first large-scale trial to demonstrate the efficacy of a home-based walking program.
Led by Tracie Collins (University of Minnesota, USA), the investigators randomized 145 individuals (mean age 66.5 years) with diabetes and symptomatic PAD to either a home-based walking therapy program or to an attention-control group for a 6-month period.
As reported in the journal Diabetes Care, the walking intervention comprised a one-on-one interaction with a research coordinator at baseline, walking training (during which participants were encouraged to complete 50-minute sessions independently), and weekly group walking classes with an instructor.
Biweekly telephone calls were also held to conduct the PACE (Patient-centered Assessment and Counseling) protocol and administer the Exercise Behaviors Questionnaire.
"Our intervention was home-based, with one weekly group walking class, and can be easily implemented in clinical practice," say the authors.
Individuals randomized to the attention-control group participated in twice-monthly phone calls to discuss their blood glucose, blood pressure, cholesterol levels, and smoking habits.
The primary outcome was 6-month change in maximal treadmill walking distance.
Secondary outcomes were maximal treadmill walking distance at 3 months and 3- and 6-month time to onset of leg pain, quality of life, lower limb function (ie, distance, speed, and stair climbing), depressive symptoms, and self-efficacy.
The researchers found that, after 6 months, there was no significant difference in the maximal treadmill walking distance or in distance walked before onset of pain between the two groups.
However, the intervention group's average walking speed improved by 5.7 points (as defined by the Walking Impairment Questionnaire scale) whereas the control group's average score decreased by 1.9 points.
They also found that the mental health quality-of-life score (as defined by the Medical Outcomes Study Short Form Survey (SF-36) subscale) increased by 3.2 units in the intervention group and decreased by 2.4 units in the control group.
The authors say the results highlight the need for development of more robust home-based walking interventions in future trials targeting people with PAD.
"Clinicians should consider recommending home-based walking therapy for such patients," the team concludes.
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By Sally Robertson