Patient Centered Home Exercise Program for Peripheral Artery Disease

Project: Research project

Project Details

Description

Lower extremity peripheral arterial disease (PAD) is a common and chronic condition that affects 8 million men and women in the United States and is associated with adverse health outcomes. People with PAD have greater functional impairment, faster rates of functional decline, and increased mobility loss compared to people without PAD. Older patients with functional impairment are less likely to remain independent in the community, have higher rates of hospitalization, and have poorer quality of life than those without functional impairment. Yet few therapies are available to help patients with PAD improve their functional performance. Supervised treadmill walking exercise programs including three or more exercise sessions per week improve treadmill walking performance in patients with PAD. However, supervised exercise programs are typically not paid for by medical insurance and require frequent travel to the exercise facility. The requirement for supervision is burdensome and most patients with PAD do not participate in supervised exercise programs. Yet current clinical practice guidelines state that there is insufficient evidence to recommend home-based walking exercise for patients with PAD.

In this proposed study, we have engaged patients with PAD and relevant stakeholders to develop a patient-centered home-based exercise intervention that improves functional outcomes that are important to patients with PAD. We have already completed substantial groundwork and obtained substantial critical input from patients with PAD. We have completed a pilot study of a new home-based exercise intervention that is acceptable and accessible to most patients with PAD. In the current proposal, we will further refine this home-based exercise intervention with the help of PAD patients. We will then test the intervention in a randomized controlled trial and disseminate results of the trial to patients and their caregivers with the assistance of relevant stakeholders. Our specific aims are as follows. First, in conjunction with patients who have PAD and healthcare providers dedicated to improving health in patients with PAD, we will develop, pilot test, and refine a home-based patient-centered exercise program for people with PAD. Second, we will conduct a randomized controlled trial to determine whether this patient-centered home-based patient-centered exercise program significantly improves patient walking performance, reduces ischemia-related leg pain, and improves other PAD patient selected outcomes. Our results will have major implications for improving health outcomes that have been selected by PAD patients and that are critically important to the large and growing number of men and women who suffer from PAD.
StatusFinished
Effective start/end date9/1/144/30/19

Funding

  • Patient-Centered Outcomes Research Institute (CER-1306-02719)

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