Abstract 13540: Characteristics of Home-Based Walking Exercise Interventions Associated With Greater Improvement in Walking Performance in Peripheral Artery Disease: A Post-Hoc Analysis of the HONOR Randomized Clinical Trial Results

Abstract

Introduction: Benefits of home-based exercise (HBE) interventions in lower extremity peripheral artery disease (PAD) are variable. This post-hoc analysis of the HONOR randomized trial studied characteristics of a home-based exercise intervention associated with greater 6-minute walk improvement in PAD. Methods: HONOR was a multi-centered randomized trial. PAD participants were randomized to either a HBE intervention or usual care for 9 months. The intervention consisted of four weekly in-person visits with an exercise coach followed by 16 telephone coaching calls over the next eight months. Participants were asked to walk for exercise five days/week, wear a Fitbit to monitor activity, upload their Fitbit on the study website, and visit the website at least weekly to view their exercise goals and monitor their progress toward exercise goals. The primary outcome was change in 6-minute walk distance at 9-month follow-up. Results: Of 200 people randomized (age 70 yrs. ±10.4, 52.5% female, 50% Black), 182 (91%) completed nine-month follow-up. Overall, the exercise intervention did not improve 6-minute walk compared to usual care [+5.5 vs. +14.4 m respectively (Mean diff: –8.9 m, 95% CI, –26.0, +8.2 m, P = .31)]. Among the 99 people randomized to HBE, change in 6-minute walk ranged from -239.2-233.7. See table for characteristics associated with greater six-minute walk improvement. Conclusion: In a home-based exercise intervention for PAD, more frequent use of the intervention website and greater exercise sessions/week, but not more time wearing a Fitbit, were associated with greater 6-minute walk improvement. Future home-based exercise interventions for PAD should help patients self-monitor exercise behavior and increase exercise sessions per week.