Home-based walking exercise in peripheral artery disease: 12-month follow-up of the GOALS randomized trial.
BACKGROUND
We studied whether a 6-month group-mediated cognitive behavioral (GMCB) intervention for peripheral artery disease (PAD) participants, which promoted home-based walking exercise, improved 6-minute walk and other outcomes at 12-month follow-up, 6 months after completing the intervention, compared to a control group.


RESULTS
We randomized PAD participants to a GMCB intervention or a control group. During phase I (months 1 to 6), the intervention used group support and self-regulatory skills during weekly on-site meetings to help participants adhere to home-based exercise. The control group received weekly on-site lectures on topics unrelated to exercise. Primary outcomes were measured at the end of phase I. During phase II (months 7 to 12), each group received telephone contact. Compared to controls, participants randomized to the intervention increased their 6-minute walk distance from baseline to 12-month follow-up, (from 355.4 to 381.9 m in the intervention versus 353.1 to 345.6 m in the control group; mean difference=+34.1 m; 95% confidence interval [CI]=+14.6, +53.5; P<0.001) and their Walking Impairment Questionnaire (WIQ) speed score (from 36.1 to 46.5 in the intervention group versus 34.9 to 36.5 in the control group; mean difference =+8.8; 95% CI=+1.6, +16.1; P=0.018). Change in the WIQ distance score was not different between the 2 groups at 12-month follow-up (P=0.139).


CONCLUSIONS
A weekly on-site GMCB intervention that promoted home-based walking exercise intervention for people with PAD demonstrated continued benefit at 12-month follow-up, 6 months after the GMCB intervention was completed.


BACKGROUND
ClinicalTrials.gov. Unique identifier: NCT00693940.
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.M.M.D., K.D., D.L.J.) Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.M.M.D., L.Z., K.L., B.S., Y.L., D.L.J.).
Mary M
MM
McDermott
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD (J.M.G.).
Jack M
JM
Guralnik
Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA (M.H.C.).
Michael H
MH
Criqui
National Institute on Aging, Bethesda, MD (L.F.).
Luigi
L
Ferrucci
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.M.M.D., L.Z., K.L., B.S., Y.L., D.L.J.).
Lihui
L
Zhao
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.M.M.D., L.Z., K.L., B.S., Y.L., D.L.J.).
Kiang
K
Liu
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.M.M.D., K.D., D.L.J.).
Kathryn
K
Domanchuk
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.M.M.D., L.Z., K.L., B.S., Y.L., D.L.J.).
Bonnie
B
Spring
Department of Health Research and Policy, Stanford University, Stanford, CA (L.T.).
Lu
L
Tian
Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL (M.K.) Jesse Brown Veterans Affairs Medical Center, Chicago, IL (M.K.).
Melina
M
Kibbe
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.M.M.D., L.Z., K.L., B.S., Y.L., D.L.J.).
Yihua
Y
Liao
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.M.M.D., K.D., D.L.J.) Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.M.M.D., L.Z., K.L., B.S., Y.L., D.L.J.).
Donald
D
Lloyd Jones
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC (J.R.).
W Jack
WJ
Rejeski
D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods; D006699:Home Care Services; D006801:Humans; D008297:Male; D009043:Motor Activity; D058729:Peripheral Arterial Disease / Q000517:prevention & control* / Q000628:therapy; D011788:Quality of Life; D013997:Time Factors; D016138:Walking
behavior change; exercise; mobility; peripheral artery disease; physical functioning