Step-monitored home exercise improves ambulation, vascular function, and inflammation in symptomatic patients with peripheral artery disease: a randomized controlled trial.

Autor: Gardner AW; Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK (A.W.G., P.S.M.) Veterans Affairs Medical Center, Oklahoma City, OK (A.W.G.)., Parker DE; Department of Biostatistics and Epidemiology, OUHSC, Oklahoma City, OK (D.E.P.)., Montgomery PS; Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK (A.W.G., P.S.M.)., Blevins SM; General Internal Medicine Section, Department of Medicine, OUHSC, Oklahoma City, OK (S.M.B.).
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2014 Sep 18; Vol. 3 (5), pp. e001107. Date of Electronic Publication: 2014 Sep 18.
DOI: 10.1161/JAHA.114.001107
Abstrakt: Background: This prospective, randomized, controlled clinical trial compared changes in primary outcome measures of claudication onset time (COT) and peak walking time (PWT), and secondary outcomes of submaximal exercise performance, daily ambulatory activity, vascular function, inflammation, and calf muscle hemoglobin oxygen saturation (StO2) in patients with symptomatic peripheral artery disease (PAD) following new exercise training using a step watch (NEXT Step) home-exercise program, a supervised exercise program, and an attention-control group.
Methods and Results: One hundred eighty patients were randomized. The NEXT Step program and the supervised exercise program consisted of intermittent walking to mild-to-moderate claudication pain for 12 weeks, whereas the controls performed light resistance training. Change scores for COT (P<0.001), PWT (P<0.001), 6-minute walk distance (P=0.028), daily average cadence (P=0.011), time to minimum calf muscle StO2 during exercise (P=0.025), large-artery elasticity index (LAEI) (P=0.012), and high-sensitivity C-reactive protein (hsCRP) (P=0.041) were significantly different among the 3 groups. Both the NEXT Step home program and the supervised exercise program demonstrated a significant increase from baseline in COT, PWT, 6-minute walk distance, daily average cadence, and time to minimum calf StO2. Only the NEXT Step home group had improvements from baseline in LAEI, and hsCRP (P<0.05).
Conclusions: NEXT Step home exercise utilizing minimal staff supervision has low attrition, high adherence, and is efficacious in improving COT and PWT, as well as secondary outcomes of submaximal exercise performance, daily ambulatory activity, vascular function, inflammation, and calf muscle StO2 in symptomatic patients with PAD.
Clinical Trial Registration Url: ClinicalTrials.gov. Unique Identifier: NCT00618670.
(© 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.)
Databáze: MEDLINE
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