McDermott MM, et al. - Researchers investigated if a home-based exercise intervention consisting of a wearable activity monitor and telephone coaching improved the walking ability over 9 months in patients with peripheral artery disease (PAD). In contrast with usual care, a home-based exercise intervention consisting of a wearable activity monitor and telephone coaching did not improve walking performance at 9-month follow-up among patients with PAD. Yielded data did not support home-based exercise interventions of wearable devices and telephone counseling without periodic onsite visits to improve walking performance in patients with PAD.

Methods

• Randomized clinical trial was performed at 3 US medical centers.
• Randomization of patients with PAD was conducted between June 18, 2015, and April 4, 2017, to home-based exercise vs usual care for 9 months.
• Final follow-up was on December 5, 2017.
• During this research, the exercise intervention group (n = 99) received 4 weekly medical center visits during the first month followed by 8 months of a wearable activity monitor and telephone coaching.
• The usual care group (n = 101) received no onsite sessions, active exercise, or coaching intervention.
• The primary outcome involved change in 6-minute walk distance at 9-month follow-up (minimal clinically important difference [MCID], 20 m).
• Secondary outcomes constituted 9-month change in subcomponents of the Walking Impairment Questionnaire (WIQ) (0-100 score; 100, best), SF-36 physical functioning score, Patient-Reported Outcomes Measurement Information System (PROMIS) mobility questionnaire (higher = better; MCID, 2 points), PROMIS satisfaction with social roles questionnaire, PROMIS pain interference questionnaire (lower = better; MCID range, 3.5-4.5 points), and objectively measured physical activity.

Results

• Amongst 200 enrollees (mean [SD] age, 70.2 [10.4] years; 105 [52.5%] women), 182 (91%) completed 9-month follow-up.
• As per the data, the mean change from baseline to 9-month follow-up in the 6-minute walk distance was discovered to be 5.5 m in the intervention group vs 14.4 m in the usual care group (difference, -8.9 m; 95% CI, -26.0 to 8.2 m; P=.31).
• The exercise intervention appeared to worsen the PROMIS pain interference score.
• It was reported that the mean change from baseline to 9 months was 0.7 in the intervention group vs -2.8 in the usual care group (difference, 3.5; 95% CI, 1.3 to 5.8; P=.002).
• No notable between-group variations were revealed in the WIQ score, the SF-36 physical functioning score, or the PROMIS mobility or satisfaction with social roles scores.