Imperial Vascular Unit, Imperial College Healthcare Trust, London, UK.
Academic Division of Surgery, Imperial College London, London, UK.
Ann Surg. 2018 Dec;268(6):1113-1118. doi: 10.1097/SLA.0000000000002300.
To evaluate the effect of using wearable activity monitors (WAMs) in patients with intermittent claudication (IC) within a single-center randomized controlled trial.
WAMs allow users to set daily activity targets and monitor their progress. They may offer an alternative treatment to supervised exercise programs (SEPs) for patients with IC.
Thirty-seven patients with IC were recruited and randomized into intervention or control group. The intervention consisted of a feedback-enabled, wrist-worn activity monitor (WAM) in addition to access to SEP. The control group was given access to SEP only. The outcome measures were maximum walking distance (MWD), claudication distance (CD), and quality of life as measured by the VascuQol questionnaire. Participants were assessed upon recruitment, and at 3, 6, and 12 months.
Patients in the WAM group showed significant improvement in MWD at 3 and 6 months (80-112 m, to 178 m; P < 0.001), which was sustained at 12 months. The WAM group also increased CD (40 vs 110 m; P < 0.001) and VascuQol score (4.7 vs 5.8; P = 0.004). The control group saw a temporary increase in VascuQol score at 6 months (4.5 vs 4.7; P = 0.028), but no other improvements in MWD or CD were observed. Significantly higher improvements in MWD were seen in the WAM group compared with that in the control group at 6 months (82 vs -5 m; P = 0.009, r = 0.47) and 12 months (69 vs 7.5 m; P = 0.011, r = 0.52).
The study demonstrates the significant, sustained benefit of WAM-led technologies for patients with IC. This potentially resource-sparing intervention is likely to provide a valuable adjunct or alternative to SEP.
在单中心随机对照试验中,评估可穿戴活动监测器(WAMs)在间歇性跛行(IC)患者中的应用效果。
WAMs 允许用户设定日常活动目标并监测进展。对于 IC 患者,它们可能是一种替代监督运动计划(SEPs)的治疗方法。
招募了 37 名 IC 患者,并将其随机分为干预组或对照组。干预组除了可以使用 SEP 外,还配备了带反馈功能的腕戴式活动监测器(WAM)。对照组仅可以使用 SEP。主要观察指标是最大步行距离(MWD)、跛行距离(CD)和 VascuQol 问卷测量的生活质量。参与者在招募时进行评估,并在 3、6 和 12 个月时进行评估。
WAM 组患者在 3 个月和 6 个月时 MWD 显著改善(80-112 m 至 178 m;P < 0.001),12 个月时仍保持改善。WAM 组还增加了 CD(40 对 110 m;P < 0.001)和 VascuQol 评分(4.7 对 5.8;P = 0.004)。对照组在 6 个月时 VascuQol 评分短暂升高(4.5 对 4.7;P = 0.028),但 MWD 或 CD 没有其他改善。在 6 个月(82 对-5 m;P = 0.009,r = 0.47)和 12 个月(69 对 7.5 m;P = 0.011,r = 0.52)时,WAM 组的 MWD 改善明显更高。
该研究表明,WAM 技术为 IC 患者带来了显著、持续的益处。这种潜在的节省资源的干预措施可能是 SEP 的一种有价值的辅助或替代方法。