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Walking at Home Improves Clogged Leg Arteries

New research shows long-term benefits for PAD patients

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June 10, 2014

CHICAGO --- New Northwestern Medicine research, representing the largest study of its kind, concludes that a home-based exercise program helped people with peripheral artery disease (PAD) walk farther and faster, according to a study published recently in the Journal of the American Heart Association. The program was beneficial even 12 months after participants started.

“The problem with supervised exercise is that it takes many visits to a cardiac rehabilitation center or other exercise facility, and it’s not covered by most medical insurance companies, including Medicare,” said Mary McGrae McDermott, M.D., lead author and the Jeremiah Stamler Professor of Medicine at Northwestern University Feinberg School of Medicine. “These results should encourage physicians to recommend walking even if their patients do not have access to a supervised exercise program.”

Affecting one in 20 Americans older than 50, PAD develops when arteries become narrowed and clogged, reducing blood flow to the legs. Previous studies have shown that supervised exercise can improve walking and lessen the symptoms of PAD, but this is the first to document the long-term benefits of a home-based walking program.

The study compared walking ability in patients and controls one year after the end of a six-month program that encouraged home-based walking. For the first six months, 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 seven through 12. 

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 controls fell slightly, from 353.1 to 345.6 meters.

The control group participated for a year in weekly educational meetings and received phone contact on unrelated PAD topics such as managing hypertension, cancer screening and vaccinations, but did not take part in the home exercise program.

According to McDermott, walking 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 this study, patients built up to 50 minutes of walking. 

“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,” 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,” McDermott said. “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 therapies can improve your health.”

The study was supported by grants R01-HL088589 and R01-HL107510 from the National Heart, Lung, and Blood Institute and the National Institute on Aging, both of the National Institutes of Health.  

-Nicole Mladic, director of communications at the Feinberg School of Medicine, is the author of this story.