Clinical Edge

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Home-Based Exercise & Walking Performance in PAD

JAMA; 2018 Apr 24; McDermott, Spring, et al

A home-based exercise intervention consisting of a wearable activity monitor and telephone coaching did not improve walking performance at 9-month follow-up among older patients (median age 70.2 years) with peripheral artery disease (PAD) compared with usual care, a recent study found. The exercise intervention group (n=99) received 4 weekly medical center visits during the first month followed by 8 months of a wearable activity monitor and telephone coaching. The usual care group (n=101) received no onsite sessions, active exercise, or coaching intervention. The primary outcome was change in 6-minute walk distance at 9-month follow-up. Researchers found:

  • The mean change from baseline to 9-month follow up in the 6-minute walk distance was 5.5 m in the intervention group vs 14.4 m in the usual care group.
  • The exercise intervention worsened the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference score, mean change from baseline to 9 months was 0.7 in the intervention group vs -2.8 in the usual care group.
  • There were no significant between-group differences in the Walking Impairment Questionnaire (WIQ) score, the SF-36 physical functioning score, or the PROMIS mobility or satisfaction with social roles scores.


McDermott MM, Spring B, Berger JS, et al. Effect of a home-based exercise intervention of wearable technology and telephone coaching on walking performance in peripheral artery disease. The HONOR randomized clinical trial. JAMA. 2018;319(16):1665–1676. doi:10.1001/jama.2018.3275.