Alternative methods for increasing physical activity in the treatment of peripheral artery disease: low-pain exercise and breaking up sitting time

Background:

PAD is a cardiovascular disease caused by atherosclerosis, resulting from risk factors such as low levels of physical activity and diabetes. High-pain structured exercise is part of best medical therapy in this population, leading to improved physical function. Additional methods of increasing physical activity such as breaking up sitting time, and low-pain structured exercise, warrant investigation.

Aims:

Firstly; to quantify differences in physical activity, and physical function, in people with type 2 diabetes (T2D) with and without PAD; secondly to determine the effect of high-pain versus low-pain structured exercise on walking ability (physical function) in people with PAD, and thirdly; to determine the efficacy of a personalised activity plan for breaking up sitting time in people with PAD, to reduce time spent sitting and improve walking ability.

Key findings:

A cross-sectional analysis revealed that the presence of PAD in T2D may have detrimental effects on physical activity and physical function. Some differences in physical activity and physical function may be related to sociodemographic and clinical differences. A network meta-analysis confirmed strong evidence in support of structured high-pain exercise, and emerging novel evidence in support of structured low-pain exercise, to improve walking ability in people with PAD. Finally, using a single-arm trial, an 8 week personalised activity plan to break up sitting time significantly improved walking ability and reduced time spent sitting in people with PAD.

Conclusions:

The presence of PAD in T2D may be detrimental to physical activity and physical function. The use of breaking up sitting time, and low-pain structured exercise, are novel treatments and may be suitable alternatives in the treatment of PAD. Large scale RCT’s are warranted to support these findings.