Total body recumbent stepping vs treadmill walking in supervised exercise therapy: A pilot study

Dereck L. Salisbury, Kari Swanson, Rebecca J Brown, Diane Treat-Jacobson

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Treadmill walking is the most commonly recommended exercise modality in supervised exercise therapy (SET) for peripheral artery disease (PAD); however, other modalities may be equally effective and more tolerable for patients. The primary aim of this single-blind, randomized pilot study was to compare the feasibility, safety, and preliminary efficacy of a treadmill walking (TM) versus a total body recumbent stepping (TBRS) exercise program for treatment of PAD (i.e., "Stepper Study").. Methods: Participants ( n = 19) enrolled in a 12-week SET program and were randomized to either a TM ( n = 9) or TBRS ( n = 10) exercise group that followed current SET exercise guidelines. Feasibility, safety, and efficacy outcomes were assessed. Results: SET attendance was 86% and 71%, respectively, for TBRS and TM groups ( p = 0.07). Session exercise dose (metabolic equivalents of task [MET] minutes) (mean [SD]) for TM was 117.6 [27.4] compared to 144.7 [28.7] in the TBRS group ( p = 0.08). Study-related adverse events were nine in 236 training hours and three in 180 training hours for the TBRS and TM groups, respectively. There were no significant differences between groups for improvement in 6-minute walk distance (mean [SD]) (TM: 133.2 ft [53.5] vs TBRS: 154.8 ft [49.8]; p = 0.77) after adjusting for baseline 6-minute walk distance. Conclusion: This is the first randomized study comparing TBRS to TM exercise in SET using current SET guidelines. This pilot study showed that TBRS is a feasible and safe exercise modality in SET. This study provides preliminary efficacy of the use of TBRS exercise in SET programs following current guidelines. Larger studies should be conducted to confirm these findings.

Original languageEnglish (US)
Pages (from-to)150-157
Number of pages8
JournalVascular Medicine (United Kingdom)
Issue number2
StatePublished - Apr 2022

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by the University of Minnesota via the Grant-in-Aid of Research, Artistry, and Scholarship Award (no. 323844).

Publisher Copyright:
© The Author(s) 2022.


  • claudication
  • exercise therapy
  • peripheral artery disease (PAD)
  • quality of life
  • walking impairment

PubMed: MeSH publication types

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


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