An Internet Based Walking Program for Patients with Peripheral Arterial Disease

随着美国人口的老龄化， 疾病（PAD）将在未来几十年内显著增加。PAD患者 发病率和死亡率风险增加，包括心血管和全因 mortality.虽然有规律的身体活动可以降低血管事件的风险， 对于PAD患者的治疗，很少有患者达到推荐的目标。锻炼计划， 增加长期坚持步行是对PAD治疗重要贡献。我们 基于互联网的干预，在步行增强的基础上建立在线社区 由我们团队成员开发的计划，并显示可提高患者的依从性 患有血管疾病的患者，如冠状动脉疾病（CAD）患者。使用 随机，对照试验研究设计，我们建议测试一个自动化的互联网介导的 一个带有社交媒体组件的步行计划，以提高长期坚持步行的能力。 同时增加患者的步行距离和健康相关生活质量（HRQOL） 关于PAD受试者将被随机分配至4组中的1组：1）每周单独电话咨询; 2） 基于互联网的量身定制的步行干预; 3）每周电话咨询和 基于互联网的量身定制的步行干预;以及4）等待列表控制。这种基于互联网的行走 与社交媒体组件的干预已被证明可以增加对 患有慢性复杂疾病的人群中的步行和总步行时间， 冠心病和糖尿病。迫切需要制定干预措施， 可推广到现实世界的人群，以提高生活方式干预的覆盖面， 在复杂的医疗条件下， 患者高风险患者，如PAD（CAD风险等同物）患者， 受益于这些方案。

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 1 of 4 arms: 1) weekly telephone counseling alone; 2) an internet-based tailored walking intervention; 3) both the weekly telephone counseling and the internet-based tailored walking intervention; and 4) wait-list control. 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.