NEW YORK (Reuters Health) – Supplementing supervised exercise programs with the use of a wearable activity monitor may boost walking distances and quality of life in patients with intermittent claudication, according to a pilot study.
“Patients in our study suffered from symptomatic peripheral vascular disease with very short walking distances, and they gained considerable benefit from using this technology,” said Pasha Normahani from Imperial College Healthcare Trust, in London.
“However, encouraging increased levels of physical activity using wearable activity trackers is likely to be beneficial for all patients with peripheral vascular disease (PVD) in order to improve their overall cardiovascular health,” he told Reuters Health by email.
Supervised exercise programs (SEPs) and the management of cardiovascular risk factors represent the mainstay of treatment for patients with intermittent claudication, but patient compliance with SEPs can be as low as 34%, according to Normahani and colleagues.
The team investigated whether the use of a feedback-enabled wrist-worn activity monitor (WAM; the Nike+ FuelBand), as a supplement to SEP, improved outcomes in their pilot study of 37 patients with intermittent claudication.
Improvements in maximum walk distance between the WAM and control groups did not differ at three months, but at six and 12 months, maximum walk distance improvements were significantly greater in the WAM group (82 and 69 m, respectively) than in the control group (-5 and 7.5 m, respectively).
Improvements in claudication distance (the distance at which symptoms of ischemic lower-limb muscle pain began) did not differ significantly at three months, but there were significantly greater improvements in the WAM group at six months (63 m vs. 10 m for controls) and 12 months (38 m vs. 11 m for controls).
Vascular quality-of-life scores were significantly better in the WAM group than in the control group at three and six months, with differences favoring WAM approaching significance at 12 months, the researchers report in Annals of Surgery, online May 11.
“The findings of this pilot study are encouraging and demonstrate that feedback-enabled activity monitors may be an effective and sustainable treatment strategy for patients suffering from claudication,” Normahani said. “Unlike currently prescribed supervised exercise programs, this intervention has the benefit of incorporating exercise into the daily routine of patients and in our study resulted in considerable improvements in walking distances and quality of life.”
“Looking forward, we plan to investigate these findings further in a multicenter study,” he said. “Of course, this technology may also be applicable to other conditions as well as pre-habilitation prior to major surgery and these also warrant further investigation.”
Normahani added, “It was surprising to find how accessible this technology was to an older patient group. Wearable exercise trackers are typically marketed towards young health conscious individuals, but the typical patient in our study was 70 years old and they really engaged with the technology.”
Dr. Joseph A. Ladapo from David Geffen School of Medicine at UCLA, in Los Angeles, who recently noted the underuse of prevention and lifestyle counseling in patients with peripheral artery disease, told Reuters Health by email, “We have a serious exercise gap in this country, and most everyone needs to be exercising more. Patients with peripheral arterial disease benefit from exercise, probably more so than the average person, so it wasn’t surprising that motivating them to move more improved their stamina and quality of life.”
“I was surprised by how well the intervention worked, in terms of how well it motivated patients to move,” said Dr. Ladapo, who was not part of the study. “Wearable devices can have variable effects on people’s levels of motivation, partly because they have variable effects on how closely people ‘self-monitor.’”
His advice for physicians: “Think creatively about what we can do to get patients moving (beyond just telling them to exercise!) and consider encouraging patients to invest in technologies that increase their engagement and physical activity.”
SOURCE: http://bit.ly/2qn3Cx3
Ann Surg 2017.
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