Relation of non-exercise walking activity with exercise performance in patients with peripheral artery disease: NEW activity for PAD.
Ryan J Mays, Rachel Kahnke, Erica N Schorr and 1 others
PMID 36898798WHAT IT FOUND
For PAD patients in a 12 week walking program, more steps outside formal sessions went with greater improvement in peak treadmill walking time.
The study was small and observational, so it cannot show extra steps caused the gain.
Key findings
01Among the 20 analysed patients, more non-exercise walking steps per week was associated with greater 12-week improvement in peak walking time (r=0.50, p=0.04), after controlling for formal exercise intensity and duration.
02Non-exercise walking showed near-significant relationships with change in claudication onset time (p=0.09), claudication onset distance (p=0.05), and WIQ distance score (p=0.07).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The final analysed sample was 20. The paper reports 22 intervention patients, five excluded from outcome testing, and two removed as extreme outliers. Only intervention patients were analysed, not controls, so the results cannot show what happens in patients who are not prescribed formal walking exercise. The study used correlations, not an experimental comparison, so it cannot show that non-exercise walking caused better treadmill performance. Missing outcome and accelerometer data were imputed, and extreme outliers were removed. Formal exercise sessions were identified from patient diaries and accelerometer data, so inaccurate diary reporting or device failure could affect the split between exercise and non-exercise walking. The paper did not identify what kinds of non-exercise walking occurred, and unreported exercise sessions may have been included in non-exercise walking. The patients also received a community-based walking program with training, monitoring and coaching, so the contribution of any single component cannot be separated.
Declared interests
The authors declared no potential conflicts of interest. The supplied publication types list NIH extramural research support, but the text does not name a funder.
The easy way to misread this
Do not conclude that adding steps outside formal exercise sessions caused better treadmill performance. The analysis was a small post hoc correlation in only intervention patients, and it cannot separate the effects of the walking program's training, monitoring, and coaching components.