A study published yesterday in JAMA found that, compared to normal care, a home-based exercise program employing wearables and telephone coaching did not help patients with peripheral artery disease (PAD) improve their walking performance over a nine-month period.

In fact, those undergoing the interventional program reported increased pain compared to those undergoing normal care.

Blood vessel blockages in the legs associated with PAD can cause pain or weakness when walking, although supervised treadmill exercise has been shown to significantly improve these patients’ walking ability. While these supervised programs are considered the first-line therapy by clinical guidelines, tech-driven interventions that do not require regular visits to a medical center have been proposed as an alternative.

"There is growing interest in using wearable activity monitors to motivate people to increase walking exercise and activity," Dr. Mary McDermott, a professor of medicine at Northwestern University Feinberg School of Medicine, said in a statement.

In the randomized trial, McDermott and colleagues enrolled 200 patients with PAD from three US medical centers to receive usual care (n = 101) or the home-based intervention (n = 99). Those in the intervention group attended weekly medical center visits during their first month of care followed by eight months of in-home support via telephone coaching and a wearable activity monitor. Those in the control did not receive any onsite sessions, active exercise, or telephone coaching.

Ninety-one percent of participants completed the full nine-month follow-up period. Among these, the average change in distance that a patient could walk within six minutes was 5.5 meters in the intervention group and 14.4 meters in the usual care group, suggesting no significant difference between the two approaches (95 percent confidence interval, –26 meters to 8.2 meters).

Similar to the study’s primary measure of interest, the researchers reported no significant differences in feedback on a number of different mobility and satisfaction questionnaires between the two groups. However, scores on a pain interference questionnaire given to the patients showed that those receiving the home-based intervention had, on average, an increase in pain while those receiving usual care reported pain reduction (score difference, 3.5; 95 percent confidence interval, 1.3 to 5.8).

“These results do not support home-based exercise interventions of wearable devices and telephone counseling without periodic onsite visits to improve walking performance in patients with PAD,” the researchers concluded.