School of Nursing, University of Minnesota, Minneapolis, MN, USA.
Current: Minneapolis VA Health Care System, Minneapolis, MN, USA.
Vasc Med. 2022 Apr;27(2):150-157. doi: 10.1177/1358863X211068888. Epub 2022 Jan 12.
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").. Participants ( = 19) enrolled in a 12-week SET program and were randomized to either a TM ( = 9) or TBRS ( = 10) exercise group that followed current SET exercise guidelines. Feasibility, safety, and efficacy outcomes were assessed. SET attendance was 86% and 71%, respectively, for TBRS and TM groups ( = 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 ( = 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]; = 0.77) after adjusting for baseline 6-minute walk distance. 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.
跑步机步行是周围血管疾病 (PAD) 监督下运动疗法 (SET) 中最常推荐的运动方式；然而，对于患者来说，其他方式可能同样有效且更耐受。本单盲、随机试验研究的主要目的是比较跑步机步行 (TM) 与全身仰卧踏步 (TBRS) 运动方案治疗 PAD 的可行性、安全性和初步疗效（即“踏步研究”）。……参与者（=19）参加了为期 12 周的 SET 计划，并随机分为 TM（=9）或 TBRS（=10）运动组，两组均遵循当前 SET 运动指南。评估了可行性、安全性和疗效结局。TBRS 和 TM 组的 SET 出勤率分别为 86%和 71%（=0.07）。TM 组的运动剂量（任务代谢当量 [MET] 分钟）（均值[标准差]）为 117.6[27.4]，TBRS 组为 144.7[28.7]（=0.08）。TBRS 和 TM 组分别有 9 次和 3 次与研究相关的不良事件，涉及 236 和 180 个训练小时。调整基线 6 分钟步行距离后，两组在 6 分钟步行距离（均值[标准差]）（TM：133.2 英尺[53.5]，TBRS：154.8 英尺[49.8]；=0.77）方面的改善无显著差异。这是第一项使用当前 SET 指南比较 TBRS 与 TM 运动在 SET 中应用的随机研究。这项试验研究表明，TBRS 是 SET 中一种可行且安全的运动方式。本研究初步证明了在遵循当前指南的 SET 计划中使用 TBRS 运动的疗效。应开展更大规模的研究以证实这些发现。
