1 | Special Topic Supplement: Vascular Diseases
home-based exercise program helped people
with clogged leg arteries walk farther and
faster, according to research in the Journal
of the American Heart Association. The
program was beneficial even 12 months after
participants started the program.
Previous studies have shown that supervised exercise
can improve walking and lessen the symptoms of peripheral
artery disease (PAD), but this is the first to document the
long-term benefits of a home-based walking program.
“The problem with supervised exercise is that it takes
many visits to a cardiac rehabilitation center or other exercise
facility, and it is not covered by Medicare,” said Mary McGrae
McDermott, M.D., lead author and the Jeremiah Stamler
professor of medicine at the Northwestern University Feinberg
School of Medicine in Chicago. “Our results should encourage
physicians to recommend walking even if their patients do not
The study compared walking ability in patients and a
control group a year after the end of a six-month program
that encouraged home-based walking. For the first six
months, 81 patients participated in weekly meetings to
provide support and skills training to help them adhere to the
home exercise program. They also received phone calls to
encourage continued walking during months 7-12.
Eighty-seven controls participated for a year in weekly
educational meetings and received phone contact on topics
unrelated to PAD such as managing hypertension, cancer
screening and vaccinations.
At 12 months, participants in the home-based program
had increased the distance they could walk in six minutes
from 355.4 to 381.9 meters, an improvement of about 87
feet. In contrast, the distance covered by the control group
fell slightly, from 353.1 to 345.6 meters.
According to McDermott, walking exercise is the most
effective non-invasive treatment for PAD, but a program must
take into account that walking may cause a cramp-like pain
in leg muscles that don’t get sufficient oxygen. By alternating
walking and rest, patients can build up the amount of time
they can walk before pain occurs.
In the home program, patients were instructed to try to
walk at least five days a week, building up to 50 minutes
per exercise session. When leg pain occurred, they were
to stop and rest until legs were comfortable again and then
“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.
“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
Source: American Heart Association News
FOR PAD PATIENTS