Abstract 12775: Supervised Exercise Therapy Adherence and Six-Minute Walk Improvement in Peripheral Artery Disease. Findings From Two Randomized Clinical Trials

Abstract

Introduction: Supervised exercise therapy (SET) is first line therapy for improving walking ability in people with peripheral artery disease (PAD), but adherence to SET is poor. The association of SET adherence with change in six-minute walk distance in PAD is unclear. Methods: Data were combined from two randomized clinical trials of SET for PAD. In both trials, participants with PAD were randomized to exercise or a control group for six months. Those randomized to SET were asked to attend 72 exercise treadmill exercise sessions over six months in the presence of an exercise physiologist. Those randomized to attention control were asked to attend up to 24 educational sessions once weekly for six months. Adherence rates were defined as the number of attended intervention or control sessions divided by the number of expected sessions. Participants randomized to SET were categorized into tertiles of adherence, according to the proportion of exercise sessions attended. Six-minute walk was measured at baseline and at 6-month follow-up. Results: 281 randomized participants (mean age: 68±9 years; 43% female; 61% African American) were included. The mean adherence rate was 75±18 % in the SET group. The adherence rates for the three SET tertiles were: ≤ 69%, 69 – 85%, and ≥ 85% respectively. Baseline characteristics, within group 6-month changes in six-minute walk distance by intervention group, and pairwise comparisons results are shown in table. Conclusion: While greater adherence to SET was associated with greater six-minute walk distance improvement, even participants with PAD in the lowest tertile of adherence had significantly greater six-minute walk improvement, compared to control. These data suggest that even intermittent exercise activity significantly improves six-minute walk in people with PAD.