Department of Surgery and Cancer, Imperial College London, London, UK.
Department of Surgery and Cancer, Imperial College London, London, UK; Institute of Global Health Innovation, Imperial College London, London, UK; Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK.
Eur J Vasc Endovasc Surg. 2021 Apr;61(4):676-687. doi: 10.1016/j.ejvs.2020.11.044. Epub 2021 Jan 12.
Intermittent claudication (IC) can severely limit functional capacity and quality of life. Supervised exercise therapy is the recommended first line management; however, this is often limited by accessibility, compliance and cost. As such, there has been an increased interest in the use of wearable activity monitors (WAMs) in home based telemonitoring exercise programmes for claudicants. This review aims to evaluate the efficacy of WAM as a feedback and monitoring tool in home based exercise programmes for patients with IC.
A search strategy was devised. The databases MEDLINE, EMBASE, and Web of Science were searched through to April 2020.
Randomised trials and prospective trials were included. Eligible trials had to incorporate WAMs as a feedback tool to target walking/exercise behaviour. The primary outcome was the change in walking ability. Study quality was assessed with risk of bias tool.
A total of 1148 records were retrieved. Of these, eight randomised controlled trials and one prospective cohort study, all of which compared a WAM intervention against standard care and/or supervised exercise, met the inclusion criteria. Owing to heterogeneity between studies, no meta-analysis was conducted. WAM interventions improved measures of walking ability (heterogeneous outcomes such as maximum walking distance, claudication distance and six minute walk distance), increased daily walking activity (steps/day), cardiovascular metrics (maximum oxygen consumption), and quality of life.
There is some evidence that home based WAM interventions are beneficial for improving walking ability and quality of life in patients with IC. However, existing studies are limited by inadequate sample size, duration, and appropriate power. Achieving consensus on outcome reporting and study methods, as well as maximising device adherence, is needed.
间歇性跛行（IC）可严重限制患者的功能能力和生活质量。有监督的运动疗法是推荐的一线治疗方法；然而，由于可及性、依从性和成本等问题，这种疗法常常受到限制。因此，人们对在基于家庭的远程监测运动计划中使用可穿戴活动监测器（WAMs）治疗跛行患者产生了更大的兴趣。本综述旨在评估 WAM 作为 IC 患者基于家庭的运动计划中的反馈和监测工具的疗效。
设计了搜索策略。通过 MEDLINE、EMBASE 和 Web of Science 数据库检索至 2020 年 4 月。
纳入了随机试验和前瞻性试验。符合条件的试验必须将 WAMs 作为反馈工具纳入，以针对步行/运动行为。主要结局是步行能力的变化。使用偏倚风险工具评估研究质量。
共检索到 1148 条记录。其中，八项随机对照试验和一项前瞻性队列研究均符合纳入标准，这些研究均将 WAM 干预与标准护理和/或有监督的运动进行了比较。由于研究之间存在异质性，因此未进行荟萃分析。WAM 干预改善了步行能力的测量（最大步行距离、跛行距离和 6 分钟步行距离等各种结果）、增加了日常步行活动（步数/天）、心血管指标（最大摄氧量）和生活质量。
有一些证据表明，基于家庭的 WAM 干预对改善 IC 患者的步行能力和生活质量有益。然而，现有研究存在样本量、持续时间和适当功率不足的局限性。需要就结果报告和研究方法达成共识，并最大限度地提高设备依从性。
