An Internet Based Walking Program for Patients with Peripheral Arterial Disease

描述（由申请人提供）：随着美国人口的老龄化，在未来几十年，患有外周动脉疾病（PAD）的成年人数量将显著增加。PAD患者的发病和死亡风险增加，包括心血管和全因死亡率。虽然有规律的身体活动可以降低血管事件的风险，并被推荐用于治疗PAD患者，但很少有患者达到推荐的目标。提高长期坚持步行的锻炼计划对PAD治疗有重要贡献。我们基于互联网的干预，与在线社区建立在步行增强计划的基础上，该计划由我们的团队成员开发，并被证明可以提高血管疾病患者（如冠状动脉疾病（CAD）患者）的依从性。采用随机对照试验研究设计，我们建议测试带有社交媒体组件的自动互联网介导的步行计划，以改善PAD患者长期坚持步行，同时增加步行距离和健康相关生活质量（HRQOL）。受试者将被随机分配到有监督的步行计划，有监督的步行与额外的在线步行干预或单独的在线步行干预。这种基于互联网的步行干预与社交媒体组成部分已被证明可以增加患有慢性复杂疾病（如冠状动脉疾病和糖尿病）的人群对步行的坚持和总步行时间。迫切需要开发易于推广到现实世界人群的干预措施，以改善生活方式干预的范围，从而改善复杂医疗患者的身体功能和坚持定期锻炼。高风险患者，如PAD（与CAD风险相当），最能从这些项目中受益。

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.