A group-mediated, home-based physical activity intervention for patients with peripheral artery disease: effects on social and psychological function.
BACKGROUND
PAD is a disabling, chronic condition of the lower extremities that affects approximately 8 million people in the United States. The purpose of this study was to determine whether an innovative home-based walking exercise program for patients with peripheral artery disease (PAD) improves self-efficacy for walking, desire for physical competence, satisfaction for physical functioning, social functioning, and acceptance of PAD related pain and discomfort.


METHODS
The design was a 6-month randomized controlled clinical trial of 194 patients with PAD. Participants were randomized to 1 of 2 parallel groups: a home-based group-mediated cognitive behavioral walking intervention or an attention control condition.


RESULTS
Of the 194 participants randomized, 178 completed the baseline and 6-month follow-up visit. The mean age was 70.66 (±9.44) and was equally represented by men and women. Close to half of the cohort was African American. Following 6-months of treatment, the intervention group experienced greater improvement on self-efficacy (p = .0008), satisfaction with functioning (p = .0003), pain acceptance (p = .0002), and social functioning (p = .0008) than the control group; the effects were consistent across a number of potential moderating variables. Change in these outcomes was essentially independent of change in 6-minute walk performance.


BACKGROUND
[ClinicalTrials.gov Identifier: NCT00693940].
Departments of Health and Exercise Science and Geriatric Medicine, Wake Forest University, Box 7867, Winston-Salem, NC 27109, USA. rejeski@wfu.edu.
W Jack
WJ
Rejeski
Bonnie
B
Spring
Kathryn
K
Domanchuk
Huimin
H
Tao
Lu
L
Tian
Lihui
L
Zhao
Mary M
MM
McDermott
D000368:Aged; D003071:Cognition / Q000502:physiology; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D009043:Motor Activity; D010146:Pain / Q000503:physiopathology / Q000523:psychology; D010349:Patient Compliance; D058729:Peripheral Arterial Disease / Q000503:physiopathology* / Q000523:psychology*; D058992:Social Participation; D016138:Walking / Q000502:physiology