Adherence and exercise mode in supervised exercise therapy for peripheral artery disease.
Kristin M Elgersma, Rebecca J L Brown, Dereck L Salisbury and 6 others
PMID 32950111WHAT IT FOUND
In PAD supervised exercise, combining treadmill and step-ex had the best adherence, while treadmill alone had the lowest.
All groups improved exercise capacity; the combined group gained more work per session than treadmill alone. Step-ex appeared safe for patients with high fall risk.
Key findings
01Participants who used both treadmill and step-ex had higher adherence than those using either mode alone, and overall adherence was 62%.
02All groups improved highest METs from baseline to 12 weeks; treadmill and multimodal changes were significant, while step-ex trended toward significance.
03Five participants were hospitalized for cardiac problems, and one participant received bypass grafting and died, but no adverse events were related to supervised exercise.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
Exercise mode was not randomized; participants and therapists chose it together, so baseline health and fall risk differed between groups. There was no control group, so change over 12 weeks cannot be separated from time or usual care. Only 53 participants were analyzed across three small groups, limiting certainty about differences between modes. The sample was all white and came from rural Midwest sites, so it may not represent other populations. Exercise data came from logs across four sites with different recording methods, and some participants exercised outside the program.
Declared interests
The supplied text states that the parent study was funded by the Margaret A. Cargill Foundation; no other funding or conflict statements are present in the supplied text.
The easy way to misread this
Do not conclude that multimodal exercise is proven better than treadmill or step-ex. The groups were not randomized, had different baseline health and fall risk, and had no control group, so the adherence and MET differences may reflect how participants were selected rather than the mode itself.