(Press-News.org) 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 physical activity in patients with PAD, according to a study in the July 3 issue of JAMA.
"Few medical therapies improve the functional impairment associated with lower extremity peripheral artery disease. Supervised treadmill exercise increases maximal treadmill walking distance by 50 percent to 200 percent in individuals with PAD. However, supervised exercise is typically not covered by medical insurance and requires regular transportation to the exercise center. Thus, few patients with PAD participate in supervised treadmill exercise therapy," according to background information in the article.
"Home-based walking exercise is a promising alternative to supervised exercise. However, several clinical trials of home-based exercise in people with PAD have been small and inconclusive. Recent, larger randomized trials have yielded mixed results. Current clinical practice guidelines state that there is insufficient evidence to recommend home-based walking exercise for people with PAD. Most physicians do not recommend home-based walking exercise to patients with PAD," the authors write.
Mary M. McDermott, M.D., of the Northwestern University Feinberg School of Medicine, Chicago, and colleagues conducted a study to determine whether a home-based walking exercise program that uses a group-mediated cognitive behavioral intervention, incorporating both group support and self-regulatory skills, can improve functional performance compared with a health education control group in patients with PAD with and without intermittent claudication (pain in the calf that typically is felt while walking and usually subsides with rest). The randomized clinical trial, conducted between July 2008 and December 2012, included 194 patients with PAD (72 percent without classic symptoms of intermittent claudication). The primary measured outcome was 6-month change in 6-minute walk performance.
The researchers found that at 6-month follow-up, participants in the intervention group improved their 6-minute walking distance compared with the control group by 1,173 to 1,312 feet vs. 1,159 to 1,123 feet for those in the control group, an average difference of 176 feet. Also, participants in the intervention group, compared with the control group, significantly improved their maximal treadmill walking time (7.91 to 9.44 minutes vs. 7.56 to 8.09 minutes); improved their pain-free walking time; increased their physical activity; improved their Walking Impairment Questionnaire (WIQ) distance score and WIQ speed score.
Participants randomized to the intervention group were about 3 times more likely to achieve a small meaningful improvement (66 feet) in the 6-minute walk and approximately 6 times more likely to achieve a large meaningful improvement (164 feet).
"Based on these findings, clinical practice guidelines should advise clinicians to recommend home-based walking programs with a weekly group-mediated cognitive behavioral intervention component for patients with PAD who do not have access to supervised exercise," the authors write. "These findings have implications for the large number of patients with PAD who are unable or unwilling to participate in supervised exercise programs."
###
(JAMA. 2013;310(1):57-65; Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Home-based walking exercise program improves speed and endurance for patients with PAD
2013-07-03
ELSE PRESS RELEASES FROM THIS DATE:
Smoking cessation, weight gain, and subsequent CHD risk
2013-07-03
"Cigarette smoking is an important cause of cardiovascular disease, and smoking cessation reduces the risk. However, weight gain after smoking cessation may increase the risk of diabetes and weaken the benefit of quitting," write Juhua Luo, Ph.D., of the Indiana University School of Public Health, Bloomington, Ind., and colleagues.
As reported in a Research Letter, the authors used data from the Women's Health Initiative (WHI) to assess the association between smoking cessation, weight gain, and subsequent coronary heart disease (CHD) risk among postmenopausal women ...
Why do we gesticulate?
2013-07-03
Professor Andrew Bass (Cornell University), who will be presenting his work at the meeting of the Society for Experimental Biology on the 3rd July, said: "We have traced the evolutionary origins of the behavioural coupling between speech and hand movement back to a developmental compartment in the brain of fishes."
"Pectoral appendages (fins and forelimbs) are mainly used for locomotion. However, pectoral appendages also function in social communication for the purposes of making sounds that we simply refer to as non-vocal sonic signals, and for gestural signalling."
Studies ...
Surviving fasting in the cold
2013-07-03
King penguin chicks survive harsh winters with almost no food by minimising the cost of energy production. A new study, to be presented at the Society for Experimental Biology meeting in Valencia on the 3rd July, shows that the efficiency of the mitochondria, the power house of the cell, is increased in fasted king penguin chicks.
King penguin chicks are socially and morphologically well adapted to harsh environmental conditions, however, they experience a severe energy challenge during the cold sub-Antarctic winter, when food is not readily available. Research headed ...
New test spots more lung clots but seems to result in overdiagnosis
2013-07-03
The introduction of CT pulmonary angiography has been associated with an 80% rise in the detection of pulmonary emboli in the US, but with little change in death rates.
Professor Renda Soylemez Wiener and colleagues argue this is evidence of overdiagnosis. They say some patients are helped, but many are harmed by the adverse effects of unnecessary treatment.
This article is the first of a series looking at the risks and harms of overdiagnosis in a range of common conditions. The series, together with the Preventing Overdiagnosis conference in September, are part of ...
Fluorescent fingerprint tag aims to increase IDs from 'hidden' prints on bullets and knives
2013-07-03
Wednesday 28th June 2013, Durham: A new way of detecting and visualizing fingerprints from crime scenes using colour-changing fluorescent films could lead to higher confidence identifications from latent (hidden) fingerprints on knives, guns, bullet casings and other metal surfaces. The technique is the result of a collaboration between the University of Leicester, the Institut Laue-Langevin and the STFC's ISIS pulsed neutron and muon source, and will be presented today at the Royal Society of Chemistry's Faraday Discussion in Durham.
When your finger touches a surface, ...
Women worldwide know less about politics than men
2013-07-03
Women living in the world's most advanced democracies and under the most progressive gender equality regimes still know less about politics than men. Indeed, an unmistakable gender gap in political knowledge seems to be a global phenomenon, according to a ten-nation study of media systems and national political knowledge funded by the Economic and Social Research Council (ESRC).
Women know less about politics than men regardless of how advanced a country is in terms of gender equality, says researcher Professor James Curran, Director of the Goldsmiths Leverhulme Media ...
A good night's sleep increases the cardiovascular benefits of a healthy lifestyle
2013-07-03
A good night's sleep can increase the benefit of exercise, healthy diet, moderate alcohol consumption and non-smoking in their protection against cardiovascular disease (CVD), according to results of a large population follow-up study.(1) Results showed that the combination of the four traditional healthy lifestyle habits was associated with a 57% lower risk of cardiovascular disease (fatal and non-fatal) and a 67% lower risk of fatal events.(2) But, when "sufficient sleep" (defined as seven or more hours a night) was added to the other four lifestyle factors, the overall ...
Workers at industrial farms carry drug-resistant bacteria associated with livestock
2013-07-03
A new study found drug-resistant bacteria associated with livestock in the noses of industrial livestock workers in North Carolina but not in the noses of antibiotic-free livestock workers. The drug-resistant bacteria examined were Staphylococcus aureus, commonly known as "Staph," which include the well-known bug MRSA (methicillin-resistant Staphylococcus aureus). New Staph strains are emerging in people who have close contact with livestock animals and for this reason have been given the name livestock-associated Staph. While everyone in the study had direct or indirect ...
Brain sets prices with emotional value
2013-07-03
DURHAM, N.C. -- You might be falling in love with that new car, but you probably wouldn't pay as much for it if you could resist the feeling.
Researchers at Duke University who study how the brain values things -- a field called neuroeconomics -- have found that your feelings about something and the value you put on it are calculated similarly in a specific area of the brain.
The region is small area right between the eyes at the front of the brain. It's called the ventromedial prefrontal cortex, or vmPFC for short. Scott Huettel, director of Duke's Center for Interdisciplinary ...
IVF for male infertility linked to increased risk of intellectual disability and autism in children
2013-07-03
In the first study to compare all available IVF treatments and the risk of neurodevelopmental disorders in children, researchers find that IVF treatments for the most severe forms of male infertility are associated with an increased risk of intellectual disability and autism in children.
Autism and intellectual disability remain a rare outcome of IVF, and whilst some of the risk is associated with the risk of multiple births, the study provides important evidence for parents and clinicians on the relative risks of modern IVF treatments.
Published in JAMA today, the ...