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Home-based exercise programs that include periodic in-person follow-up improve walking performance in patients with peripheral artery disease (PAD). In this multisite study, researchers assessed whether an exercise program in which patients rely on wearable activity monitors and telephone coaching also might be effective.
Two hundred PAD patients (mean age, 70) were randomized to a home-based exercise program or usual care. The intervention group received four weekly in-person coaching sessions during the first month, wearable activity monitors that provided activity data to a coach, and periodic phone calls from the coach for the remaining 8 months of the trial. Usual-care participants received no interventions. Both groups were contacted by telephone periodically to collect information on adverse events and physical activity.
At baseline, mean 6-minute walk distance was 330 m in both groups. At 9 months, mean walk distance did not change substantially in either group. More adverse events were reported in the intervention group, but none resulted in study termination.
McDermott MM et al. Effect of a home-based exercise intervention of wearable technology and telephone coaching on walking performance in peripheral artery disease: The HONOR randomized clinical trial. JAMA 2018 Apr 24; 319:1665. (https://doi.org/10.1001/jama.2018.3275)
Comment
In some studies, wearable activity monitors have not resulted in exercise increases in healthy people, so the lack of benefit in PAD patients is not surprising. In-person monitoring and support might be needed to achieve improved mobility in home-based exercise programs for patients with PAD.