Influence of Changes in Sedentary Time on Outcomes of Supervised Exercise Therapy in Individuals with Comorbid Peripheral Artery Disease and Type 2 Diabetes
Open accessAbstract
Background Although supervised exercise therapy (SET) is effective in improving walking distance among adults with symptomatic peripheral artery disease (PAD), some research suggests that individuals with comorbid PAD and type 2 diabetes mellitus (T2DM) may experience a blunted response to SET. It is unknown whether free-living sedentary time changes during SET, and if increases in sedentary time could, in part, explain poor response to SET. The purposes of this pilot study were to (1) determine if older adults with PAD (with and without T2DM) engaging in SET change their sedentary behavior and (2) examine the relationship between changes in sedentary behavior and SET outcomes. We hypothesized that decreased sedentary time during SET would be associated with greater improvements in six-minute walk test (6MWT) total distance and other key SET outcomes.Methods Participants (n = 44) initiating a 12-week SET program completed the 6MWT, Short Physical Performance Battery, Walking Impairment Questionnaire, and accelerometer-assessed sedentary behavior at SET initiation, 6 weeks, and 12 weeks.Results Participants' mean age was 72.3 (7.1) years, mean ankle-brachial index was 0.71 (0.25), and 47.7% were female. On average, sedentary time did not change after SET, although there was substantial variability (-40% to +38% change in minutes of sedentary time/day). Participants with T2DM experienced greater improvements in claudication onset distance than participants without T2DM (mean = 35 m, P = 0.044, 95% confidence interval = 1.6 to 115.4 m). Neither changes in sedentary time from baseline to 6 weeks (P = 0.419) nor T2DM (P = 0.154) predicted changes in 6MWT total distance from baseline to 12 weeks.Conclusions As SET availability increases, further examination of factors that may influence SET outcomes will help maximize benefits of this proven therapy.
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When non-response was defined as a negative or no change in the 6-minute walk test distance, its prevalence was 35%; when defined as a lack of clinically meaningful change (20 meters), non-response prevalence was as high as 56%.
“When non-response was defined as a negative or no change in the 6-minute walk test distance, its prevalence was 35%. However, when defined as a lack of clinically meaningful change (20 meters), non-response prevalence was as high as 56% [618].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [618]
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- Authors
- Whipple, M. O., Schorr, E. N., Talley, K. M. C., Wolfson, J., Lindquist, R., Bronas, U. G., & Treat-Jacobson, D.
- Affiliations
- University of Minnesota (US)
- University of Illinois Chicago (US)
- Corresponding author
- Whipple, Mary O.
- Venue
- Annals of Vascular Surgery
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 68
- Pages
- 369-383
- ISSN
- 0890-5096 (ISSN-L)
- PMC
- PMC7529715
- OpenAlex
- W3016095120
- Cited by
- 18
- References
- 67
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 2
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Annals of Vascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Midwest Nursing Research Society
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- sedentary behavior, supervised exercise therapy, peripheral arterial disease, type 2 diabetes, comorbidities, 6-minute walk test, walking distance, older adults, physical activity, gait disturbance
- MeSH terms
- Aged, Diabetes Mellitus, Type 2, Exercise Therapy, Female, Humans, Intermittent Claudication, Male, Minnesota, Pilot Projects, Time Factors, Comorbidity, Walking, Treatment Outcome, Exercise Tolerance, Recovery of Function, Sedentary Behavior, Peripheral Arterial Disease
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