An Internet Based Walking Program for Patients with Peripheral Arterial Disease

描述(申请人提供)：随着美国人口老龄化，在接下来的几十年里，患有外周动脉疾病(PAD)的成年人数量将显著增加。PAD患者的发病率和死亡率增加，包括心血管和所有原因的死亡率。虽然有规律的体力活动可以降低血管事件的风险，并被推荐用于PAD患者的治疗，但很少有患者达到推荐的目标。增加长期坚持步行的锻炼计划是对PAD治疗的重要贡献。我们的基于互联网的干预，以及一个在线社区，建立在我们团队成员开发的步行增强计划的基础上，并被证明可以提高冠状动脉疾病(CAD)等血管疾病患者的依从性。使用随机对照试验研究设计，我们建议测试一种带有社交媒体组件的自动互联网中介步行计划，以改善PAD患者在增加步行距离和健康相关生活质量(HRQOL)的同时长期坚持步行的情况。受试者将被随机分为监督步行计划、监督步行和额外的在线步行干预或单独进行在线步行干预。这项基于互联网、带有社交媒体成分的步行干预已被证明在患有冠心病和糖尿病等慢性复杂疾病的人群中增加了对步行的坚持和总体步行时长。迫切需要开发易于推广到真实世界人口的干预措施，以改善生活方式干预的覆盖范围，从而改善复杂内科患者的身体功能并坚持定期锻炼。高危患者，如那些患有PAD(相当于冠心病风险)的患者，将从此类计划中受益最多。

DESCRIPTION (provided by applicant): With the aging of the American population, the numbers of adults with peripheral arterial disease (PAD) will increase significantly over the next several decades. Patients with PAD are at increased risk for morbidity and mortality including both cardiovascular and all cause mortality. While regular physical activity reduces risk for vascular events and is recommended for treatment of PAD patients, few patients meet recommended goals. Exercise programs which increase long-term adherence to walking be an important contribution to PAD treatment. Our internet-based intervention, with an online community builds on a walking enhancement program develop by members of our team and shown to improve adherence among patients with vascular disease such as patients with coronary artery disease (CAD). Using a randomized, controlled trial study design, we propose to test an automated internet-mediated walking program with a social media component, to improving long-term adherence to walking while increasing walking distance, and health-related quality of life (HRQOL), among patients with PAD. Subjects will be randomized to a supervised walking program, supervised walking with an additional online walking intervention or an online walking intervention alone. This internet based walking intervention with a social media component has been shown to increase both adherence to walking and overall walking duration in populations with chronic complex conditions such as coronary artery disease and diabetes. There is a strong need to develop interventions, easily generalizable to a real-world population, to improve the reach of lifestyle interventions which result in improved physical function and adherence to regular exercise among complex medical patients. High risk patients such as those with PAD (a CAD risk equivalent) stand the most to benefit from such programs.