title: Effects of a home-based walking intervention on mobility and quality of life in people with diabetes and peripheral arterial disease: a randomized controlled trial.
abstract: OBJECTIVE
  Determine the efficacy of a home-based walking intervention to improve walking ability and quality of life in people with diabetes and peripheral arterial disease (PAD).
  
  
  METHODS
  We conducted a randomized, controlled, single-blind trial within university-affiliated clinics in our local community. We randomized 145 participants (45 women) with diabetes and PAD to our intervention--a 6-month behavioral intervention targeting levels of readiness to engage in routine walking for exercise--versus attention control. Our primary outcome was 6-month change in maximal treadmill walking distance. Secondary outcomes included 3-month change in maximal walking distance, lower limb function (i.e., walking impairment scores), quality of life (Medical Outcomes Short Form Survey), exercise behaviors, depressive symptoms, and self-efficacy at 3 and 6 months.
  
  
  RESULTS
  The mean age of participants was 66.5 (SD 10.1) years. Intervention and control groups did not differ significantly in 6-month change in maximal treadmill walking distance (average [SE] 24.5 [19.6] meters vs. 39.2 [19.6] meters; P = 0.60). Among secondary outcomes, for the intervention and control groups, respectively, average walking speed scores increased by 5.7 [2.2] units and decreased by 1.9 [2.8] units (P = 0.03); the mental health quality of life subscale score increased by 3.2 [1.5] and decreased by 2.4 [1.5] units (P = 0.01).
  
  
  CONCLUSIONS
  A home-based walking intervention did not improve walking distance but did improve walking speed and quality of life in people with diabetes and PAD. Clinicians should consider recommending home-based walking therapy for such patients.
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA. tcc@umn.edu
authors.forename: Tracie C
authors.initials: TC
authors.lastname: Collins
authors.forename: Scott
authors.initials: S
authors.lastname: Lunos
authors.forename: Teri
authors.initials: T
authors.lastname: Carlson
authors.forename: Kimberly
authors.initials: K
authors.lastname: Henderson
authors.forename: Marissa
authors.initials: M
authors.lastname: Lightbourne
authors.forename: Brittney
authors.initials: B
authors.lastname: Nelson
authors.forename: James S
authors.initials: JS
authors.lastname: Hodges
mesh_terms: D000368:Aged; D003920:Diabetes Mellitus / Q000628:therapy*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000628:therapy*; D011788:Quality of Life; D016138:Walking / Q000502:physiology*