Monday, 23 September 2013

New research could help millions of Americans reduce leg pain from peripheral artery disease



by Will Ferguson

A new approach to treating peripheral artery disease could lead to happier and healthier lives for millions of Americans.


Peripheral artery disease (PAD) limits the flow of oxygen-rich blood to your legs and other parts of the body. This debilitating affliction can make walking painful and affects an estimated 12 million Americans.


"The best thing for this patient population is to try and get them moving," said Jack Rejeski, a professor of health and exercise science and the director of the Behavioral Medicine Laboratory at Wake Forest. "If you don't, they become further impaired, an effect that can severely compromise quality of life."


Rejeski is a co-author of a new study that shows for the first time a home-based can increase the walking distance and reduce the lower of people with PAD.


He said previous studies have shown supervised improves mobility and can reduce leg pain during activity for people with PAD. However, supervised exercise typically is not covered by and requires the availability of and access to such programs.


"Unfortunately what happens with PAD is that many people can't afford supervised care or do not have access to such care," Rejeski said. "To make matters worse, there has been no evidence that patients with PAD will engage in or can benefit from home-based exercise."


Until now.


Rejeski is the senior author of a new study that shows for the first time that home-based can be implemented with success for people with PAD.


The Group Oriented Arterial Leg Study (GOALS) was performed in collaboration with researchers at Northwestern University's School of Medicine in Chicago with Dr. Mary McDermott as the principal investigator. It appeared in the July 3, 2013 issue of the Journal of the American Medical Association.


Rejeski said participants in the study, aged 65 and older, were randomly assigned to either an or a control group. Each group met one time weekly for six months. Participants in the intervention group were taught how to develop a home-based program with a focus on goal-setting, self-monitoring and pain management. They were instructed to engage in 50-minute walking exercises at home up to five times a week. Rejeski said the intervention group also benefited from the support of other participants and their group leader. Participants in the control group attended weekly 60-minute lectures by health professionals on topics like managing hypertension, cancer screening and vaccinations.


Prior to and at the end of six months, both groups performed a six-minute walking test. Rejeski said participants in the intervention group were able to walk 53.5 meters further than the .


"From a clinical standpoint, this is a significant result," Rejeski said. "It will change the current clinical practice guidelines that apply to people with PAD."


Rejeski said the key to a successful home-based PAD program is a group-mediated approach which provides the support and skills needed to sustain an independent program of physical activity for patients with PAD.


"The participants can identify with other people with the disease and also talk about what has and hasn't worked for them," he said. "What this study shows is that if you can get people to understand the value of being physically active, and they can work with and feel supported by others who understand what they facing, they can and often become accountable for self-managing the symptoms of their disease. "


Rejeski is currently working with his colleagues at Northwestern University on a follow-up grant using mobile technological to deliver this invention to PAD patients so that it can be accessible to a larger segment of the population.


The study, still in its early stages, uses iPhones equipped with accelerometers to track and provide real-time feedback on physical activity performed at home. The group-based component of the intervention is delivered via telephone and is coordinated and facilitated by a coach.


"This new study will not only help keep participants accountable, but is also a way to feed information back to them so they can monitor their progress," Rejeski said. "The idea is to merge technology with state-of-the-art methods for behavioral change."



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by Will Ferguson

A new approach to treating peripheral artery disease could lead to happier and healthier lives for millions of Americans.


Peripheral artery disease (PAD) limits the flow of oxygen-rich blood to your legs and other parts of the body. This debilitating affliction can make walking painful and affects an estimated 12 million Americans.


"The best thing for this patient population is to try and get them moving," said Jack Rejeski, a professor of health and exercise science and the director of the Behavioral Medicine Laboratory at Wake Forest. "If you don't, they become further impaired, an effect that can severely compromise quality of life."


Rejeski is a co-author of a new study that shows for the first time a home-based can increase the walking distance and reduce the lower of people with PAD.


He said previous studies have shown supervised improves mobility and can reduce leg pain during activity for people with PAD. However, supervised exercise typically is not covered by and requires the availability of and access to such programs.


"Unfortunately what happens with PAD is that many people can't afford supervised care or do not have access to such care," Rejeski said. "To make matters worse, there has been no evidence that patients with PAD will engage in or can benefit from home-based exercise."


Until now.


Rejeski is the senior author of a new study that shows for the first time that home-based can be implemented with success for people with PAD.


The Group Oriented Arterial Leg Study (GOALS) was performed in collaboration with researchers at Northwestern University's School of Medicine in Chicago with Dr. Mary McDermott as the principal investigator. It appeared in the July 3, 2013 issue of the Journal of the American Medical Association.


Rejeski said participants in the study, aged 65 and older, were randomly assigned to either an or a control group. Each group met one time weekly for six months. Participants in the intervention group were taught how to develop a home-based program with a focus on goal-setting, self-monitoring and pain management. They were instructed to engage in 50-minute walking exercises at home up to five times a week. Rejeski said the intervention group also benefited from the support of other participants and their group leader. Participants in the control group attended weekly 60-minute lectures by health professionals on topics like managing hypertension, cancer screening and vaccinations.


Prior to and at the end of six months, both groups performed a six-minute walking test. Rejeski said participants in the intervention group were able to walk 53.5 meters further than the .


"From a clinical standpoint, this is a significant result," Rejeski said. "It will change the current clinical practice guidelines that apply to people with PAD."


Rejeski said the key to a successful home-based PAD program is a group-mediated approach which provides the support and skills needed to sustain an independent program of physical activity for patients with PAD.


"The participants can identify with other people with the disease and also talk about what has and hasn't worked for them," he said. "What this study shows is that if you can get people to understand the value of being physically active, and they can work with and feel supported by others who understand what they facing, they can and often become accountable for self-managing the symptoms of their disease. "


Rejeski is currently working with his colleagues at Northwestern University on a follow-up grant using mobile technological to deliver this invention to PAD patients so that it can be accessible to a larger segment of the population.


The study, still in its early stages, uses iPhones equipped with accelerometers to track and provide real-time feedback on physical activity performed at home. The group-based component of the intervention is delivered via telephone and is coordinated and facilitated by a coach.


"This new study will not only help keep participants accountable, but is also a way to feed information back to them so they can monitor their progress," Rejeski said. "The idea is to merge technology with state-of-the-art methods for behavioral change."



Medical Xpress on facebook

Related Stories


Home-based walking exercise program improves speed and endurance for patients with PAD


Jul 02, 2013



In a trial that included nearly 200 participants with peripheral artery disease (PAD), a home-based exercise intervention with a group-mediated cognitive behavioral intervention component improved walking performance and ...



Treadmill exercise improves walking endurance for patients with peripheral arterial disease


Jan 13, 2009



Patients with peripheral arterial disease (PAD), which can include symptoms such as pain in the legs, who participated in supervised treadmill exercise improved their walking endurance and quality of life, according to a ...



Exercise improves walking in peripheral arterial disease patients


Jan 14, 2009



Charles Meadows measured his life in footsteps. How far to walk to reach the milk in the grocery store? Could he make it to the dairy case before cramps knifed through his left leg, immobilizing him and leaving him breathless ...



Antioxidants may ease PAD blood pressure increase


Nov 08, 2012



Low antioxidant levels contribute to increased blood pressure during exercise for people with peripheral arterial disease, according to researchers at Penn State Hershey Heart and Vascular Institute.



Can stem cell boost, treadmill use improve artery disease?


Nov 01, 2011



(Medical Xpress) -- Northwestern Medicine researchers have launched a clinical trial testing a new combination of treadmill exercise and drug regimen to see if the two together improve the walking ability of people with peripheral ...



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New model better predicts risk of post-PCI bleeding


Sep 21, 2013



(HealthDay)—A new definition of post-percutaneous coronary intervention (PCI) bleeding and a new predictive risk model can better identify patients at risk for bleeding complications, according to a study ...





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Sep 20, 2013



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Sep 20, 2013



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Sep 20, 2013



Researchers at the University of Leicester and Glenfield Hospital have successfully used a novel "paper-clip" sized vascular coupling device to tackle resistant high blood pressure.





Increased QRS duration on ECG tied to cardiovascular mortality


Sep 19, 2013



(HealthDay)—Increased QRS duration on electrocardiogram (ECG) is an independent predictor of cardiovascular mortality, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.





Researchers envision switching a heart beat on and off with light


Sep 19, 2013



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