Title

A modified activity protocol for claudication

Document Type

Journal Article

Publication Date

6-1-2019

Journal

Journal of Cardiovascular Surgery

Volume

60

Issue

3

DOI

10.23736/S0021-9509.18.10021-8

Keywords

Arterial Occlusive Diseases; Exercise; Intermittent claudication; Veterans

Abstract

© 2018 EDIZIONI MINERVA MEDICA. BACKGROUND: We propose the use of a monitored step tracking device, the FitBit® to supplant supervised exercise therapy (SET) programs to facilitate improvement in walking distance in veteran claudicators. METHODS: In this prospective study, we enrolled forty-nine patients with clinical evidence of lower extremity claudication in a six-month walking program. Each patient was given a FitBit® device to track daily number of steps. Patients were seen in clinic monthly to collect data and discuss walking goals. Surveys at the beginning and end of each study assessed patient perception of changes in walking distance as well as symptoms. The primary outcome was monthly distance walked. Changes over time in each outcome variables were examined using a random effects mixed model. RESULTS: In the first month, the adjusted mean number of steps per day was 3492 (95% CI: 2661-4322). By month 5, this had increased to 4502 (3636-5367) (P=0.0007). Twenty-eight patients used the tracker at least for 1 month, while 21 (43%) did not. Being bothered by symptoms was the only patient variable that was significantly associated with use of the FitBit®. Those who used the tracker tended to be younger, heavier, more active, and were more likely to have diabetes. CONCLUSIONS: In the veteran population, the use of a monitored step tracking device such as the FitBit® is a potentially effective strategy to improve walking distance in claudicators particularly in those with mild symptoms. Additional investigation is needed to determine which patients will benefit most from this walking protocol.

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