Effects of Walking Exercise at a Pace With Versus Without Ischemic Leg Symptoms on Functional Performance Measures in People With Lower Extremity Peripheral Artery Disease: The LITE Randomized Clinical Trial

Michael M. Hammond, Bonnie Spring, W. Jack Rejeski, Robert Sufit, Michael H. Criqui, Lu Tian, Lihui Zhao, Shujun Xu, Melina R. Kibbe, Christiaan Leeuwenburgh, Todd Manini, Daniel E. Forman, Diane Treat-Jacobson, Tamar S. Polonsky, Lydia Bazzano, Luigi Ferrucci, Jack Guralnik, Donald M. Lloyd-Jones, Mary M. McDermott

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: In people with peripheral artery disease, post hoc analyses of the LITE (Low Intensity Exercise Intervention in Peripheral Artery Disease) randomized trial were conducted to evaluate the effects of walking exercise at a pace inducing ischemic leg symptoms on walking velocity and the Short Physical Performance Battery, compared with walking exercise without ischemic leg symptoms and compared with a nonexercising control group. METHODS AND RESULTS: Participants with peripheral artery disease were randomized to: home-based walking exercise that induced ischemic leg symptoms; home-based walking exercise conducted without ischemic leg symptoms; or a nonexer-cising control group for 12 months. Outcomes were change of walking velocity over 4 m and change of the Short Physical Performance Battery (0–12, with 12=best) at 6-and 12-month follow-up. A total of 264 participants (48% women, 61% Black race) were included. Compared with walking exercise without ischemic symptoms, walking exercise that induced ischemic symptoms improved change in usual-paced walking velocity over 4 m at 6-month (0.056 m/s [95% CI, 0.019–0.094 m/s]; P<0.01) and 12-month follow-up (0.084 m/s [95% CI, 0.049–0.120 m/s]; P<0.01), change in fast-paced of walking velocity over 4 m at 6-month follow-up (P=0.03), and change in the Short Physical Performance Battery at 12-month follow-up (0.821 [95% CI, 0.309–1.334]; P<0.01). Compared with control, walking exercise at a pace inducing ischemic symptoms improved change in usual-paced walking velocity over 4 m at 6-month follow-up (0.066 m/s [95% CI, 0.021–0.111 m/s]; P<0.01). CONCLUSIONS: In people with peripheral artery disease, those who walked for exercise at a comfortable pace without ischemic leg symptoms slowed their walking speed during daily life and worsened the Short Physical Performance Battery score, a po-tentially harmful effect, compared with people who walked for exercise at a pace inducing ischemic leg symptoms. Compared with a control group who did not exercise, home-based walking exercise at a pace inducing ischemic leg symptoms significantly improved change of walking velocity over 4 m at 6-month follow-up, but this benefit did not persist at 12-month follow-up.

Original languageEnglish (US)
Article numbere025063
JournalJournal of the American Heart Association
Volume11
Issue number15
DOIs
StatePublished - Aug 2 2022

Bibliographical note

Funding Information:
This work was funded by the American Heart Association (Strategically Focused Research Network [SFRN] grant: 18SFRN339700097). The LITE (Low Intensity Exercise Intervention in Peripheral Artery Disease) randomized trial was funded by grant R01-HL122846 from the National Heart, Lung, and Blood Institute and supported by the National Institute on Aging Intramural Division and by the Jesse Brown Veterans Affairs (VA) Medical Center.

Publisher Copyright:
© 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Keywords

  • functional performance
  • peripheral artery disease
  • randomized clinical trial
  • walking exercise

PubMed: MeSH publication types

  • Journal Article
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

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