Efficacy of Quantified Home-Based Exercise and Supervised Exercise in Patients With Intermittent Claudication: A Randomized Controlled Trial
Open accessAbstract
Background—: This prospective, randomized, controlled clinical trial compared changes in exercise performance and daily ambulatory activity in peripheral artery disease patients with intermittent claudication after a home-based exercise program, a supervised exercise program, and usual-care control. Methods and Results—: Of the 119 patients randomized, 29 completed home-based exercise, 33 completed supervised exercise, and 30 completed usual-care control. Both exercise programs consisted of intermittent walking to nearly maximal claudication pain for 12 weeks. Patients wore a step activity monitor during each exercise session. Primary outcome measures included claudication onset time and peak walking time obtained from a treadmill exercise test; secondary outcome measures included daily ambulatory cadences measured during a 7-day monitoring period. Adherence to home-based and supervised exercise was similar ( P =0.712) and exceeded 80%. Both exercise programs increased claudication onset time ( P <0.001) and peak walking time ( P <0.01), whereas only home-based exercise increased daily average cadence ( P <0.01). No changes were seen in the control group ( P >0.05). The changes in claudication onset time and peak walking time were similar between the 2 exercise groups ( P >0.05), whereas the change in daily average cadence was greater with home-based exercise ( P <0.05). Conclusions—: A home-based exercise program, quantified with a step activity monitor, has high adherence and is efficacious in improving claudication measures similar to a standard supervised exercise program. Furthermore, home-based exercise appears more efficacious in increasing daily ambulatory activity in the community setting than supervised exercise. Clinical Trial Registration—: URL: http://www.ClinicalTrials.Gov . Unique identifier: NCT00618670.
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Evidence for the efficacy of home-based exercise or physical activity behavioral interventions for improving exercise capacity in patients with peripheral arterial disease is equivocal.
“Evidence for the efficacy of home-based exercise or PA behavioral interventions for improving exercise capacity in patients with PAD is equivocal. Some trials have demonstrated a significant improvement in functional capacity with home-based exercise training [ 148 , 149 ], whereas others have not [ 150 , 151 ].”
From Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the American Society for Preventive Cardiology Part II: Physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations (2022) · cites this paper as [149]
Experimental — accuracy not yet measuredRandomized trials showed that wearable-guided exercise prescriptions improve walking ability, speed and oxygen consumption.
“Randomized trials showed that wearable-guided exercise prescriptions improve walking ability, speed and oxygen consumption88,89”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [89]
Two randomized trials of more than 100 patients with peripheral vascular disease using the StepWatch 3 accelerometer showed that wearable-guided exercise prescriptions were associated with significant improvement in walking ability.
“Two randomized trials of >100 patients with peripheral vascular disease, each utilizing the ankle-based accelerometer StepWatch 3 (Modus, USA), showed that wearable-guided exercise prescriptions were associated with a significant improvement in walking ability, speed and peak oxygen consumption88,89.”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [89]
Two randomized trials of more than 100 patients with peripheral vascular disease using the StepWatch 3 accelerometer showed that wearable-guided exercise prescriptions were associated with significant improvement in walking speed.
“Two randomized trials of >100 patients with peripheral vascular disease, each utilizing the ankle-based accelerometer StepWatch 3 (Modus, USA), showed that wearable-guided exercise prescriptions were associated with a significant improvement in walking ability, speed and peak oxygen consumption88,89.”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [89]
Two randomized trials of more than 100 patients with peripheral vascular disease using the StepWatch 3 accelerometer showed that wearable-guided exercise prescriptions were associated with significant improvement in peak oxygen consumption.
“Two randomized trials of >100 patients with peripheral vascular disease, each utilizing the ankle-based accelerometer StepWatch 3 (Modus, USA), showed that wearable-guided exercise prescriptions were associated with a significant improvement in walking ability, speed and peak oxygen consumption88,89.”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [89]
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- Authors
- Gardner, A. W., Parker, D. E., Montgomery, P. S., Scott, K. J., & Blevins, S. M.
- Affiliations
- University of Oklahoma Health Sciences Center (US)
- Venue
- Circulation
- Published
- 2011-02-08
- Volume
- 123
- Issue
- 5
- Pages
- 491-498
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC3154843
- OpenAlex
- W2108829308
- Cited by
- 323
- References
- 29
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 20 · 2023: 15 · 2022: 26 · 2021: 29 · 2020: 21 · 2019: 26 · 2018: 15 · 2017: 23 · 2016: 21 · 2015: 24 · 2014: 29 · 2013: 25 · 2012: 24
- FWCI
- 25.96
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R01AG024296)
- National Center for Research Resources (M01RR014467)
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- intermittent claudication, peripheral arterial disease, home-based exercise, supervised exercise, exercise adherence, ambulatory activity, walking distance, exercise performance
- MeSH terms
- Aged, Ambulatory Care, Exercise Therapy, Female, Home Care Services, Humans, Intermittent Claudication, Male, Middle Aged, Pain, Patient Compliance, Walking, Treatment Outcome, Peripheral Arterial Disease
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