Globally, disorders that impact blood vessels and the heart, known as cardiovascular diseases (CVDs), contribute to nearly 18 million deaths every year. One condition that also belongs under the umbrella of CVD but that may not always be front and centre is peripheral artery disease or PAD (1).
PAD is a condition caused by the accumulation of plaque in the arteries. This build-up triggers the narrowing of these arteries, thereby decreasing the flow of blood to affected areas of the body (2). The legs are a common site where PAD occurs (2;3). People with PAD experience the disease differently when it comes to symptoms and complications. Some may have no symptoms, whereas others may deal with mild or severe symptoms—such as pain in the legs when physically active (2-5). Symptoms like leg pain can lead folks with PAD to become less active, further diminishing their heart health (3;6-8). The ability to perform activities of daily living may also be affected, and in severe cases, amputation may become necessary. Together these issues set the foundation for a reduced quality of life among people with PAD (4).
Currently, a recommended treatment option is engaging in exercise, namely facility-based supervised exercise programs (3;9). However, even outside of a pandemic, there are many barriers to accessing such programs including the lack of widespread availability of programming (3;10), remote or rural living, mobility issues, and challenges around transportation.
Can such barriers be overcome? Let’s turn to a recent systematic review investigating whether structured home exercise is an effective option for people living with PAD in their legs (3).
What the research tells us
Within the review, home exercise programs generally included: walking as a form of physical activity; contact with a professional—psychologist, counsellor, or exercise specialist—for motivation; and recommendations to exercise three to five times a week. The treadmill test (i.e., walking performed on a treadmill) and the 6-minute walking test (i.e., the distance a participant is able to walk over six-minutes) were used to measure walking performance, while accelerometers or pedometers were used to measure activity levels.
The results show small but statistically significant improvements in the maximum distance walked and the distance walked before experiencing leg pain in people with PAD in their legs who engage in structured home exercise programs, compared to those not exercising. Physical activity levels also went up. All of these enhancements were seen over the short-term (6 months or less).
For those with leg PAD who can’t access a supervised exercise program or prefer non-facility based exercise, speak with your health care provider (e.g., physician, vascular specialist, cardiologist, etc.) about whether a structured home exercise program is the next best option for you. Work with your provider to develop a program that takes into consideration your limitations, individual needs, and safety.