A Hybrid Rehabilitation Program for Adults with Peripheral Artery Disease (HY-PAD): A Pre-Post Intervention Study to Assess Its Feasibility

Abstract

Background

Supervised exercise programs improve walking impairment and quality of life (QoL) in patients with peripheral artery disease (PAD). However, such programs are underutilized, due to their limited accessibility. A feasible and effective exercise program is needed. This study assessed the feasibility of a hybrid onsite and home-based exercise program (HY-PAD) and changes in walking capacity and PAD-specific QoL following HY-PAD.

Methods

Due to recruitment challenges imposed by the COVID-19 pandemic, this randomized controlled trial was modified to a pre–post intervention design that excluded the control group. Eligible patients with PAD were assigned to HY-PAD, consisting of 1-hour, supervised onsite exercise sessions 3 days per week for 4 weeks, followed by a home-based program with weekly 15-minute telephone calls to discuss exercise planning for 8 weeks. Feasibility was determined based on recruitment, adherence, and adverse events. Walking capacity was measured by a 6-minute walk test. PAD-specific QoL was assessed using the Walking Impairment Questionnaire.

Results

Of 24 patients enrolled (3 women, aged 70 ± 8 years), 21 (87.5%) completed HY-PAD. Twenty participants attended ≥ 87.5% of prescribed sessions. Two participants experienced adverse events (foot injury and limb ischemia). The 6-minute walk test distance (357 ± 105 vs 413 ± 53 meters, P = 0.021), and 2 domains of the questionnaires (walking speed: 38.4 ± 24.1 vs 60.6 ± 26.6 points and stair-climbing: 60.6 ± 29.4 vs 74.0 ± 23.1 points, both P < 0.001) increased significantly.

Conclusions

High attendance and low dropout rates support the feasibility of using HY-PAD, which was associated with improved walking capacity and PAD-specific QoL. Future studies are warranted to confirm its efficacy.