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A Journal on Cardiac, Vascular and Thoracic Surgery

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The Journal of Cardiovascular Surgery 2018 Jan 23

DOI: 10.23736/S0021-9509.18.10021-8


language: English

A modified activity protocol for claudication

Kendal M. ENDICOTT , Conor F. HYNES, Richard AMDUR, Robyn MACSATA

Division of Vascular Surgery, Washington DC Veteran’s Affairs Medical Center, Washington DC, USA


BACKGROUND: We propose the use of a monitored step tracking device, the FitBit® to supplant supervised exercise therapy (SET) programs to facilitate improvement in walking distance in Veteran claudicators.
METHODS: In this prospective study, we enrolled fortynine patients with clinical evidence of lower extremity claudication in a six month walking program. Each patient was given a FitBit® device to track daily number of steps. Patients were seen in clinic monthly to collect data and discuss walking goals. Surveys at the beginning and end of each study assessed patient perception of changes in walking distance as well as symptoms. The primary outcome was monthly distance walked. Changes over time in each outcome variables were examined using a random effects mixed model.
RESULTS: In the first month, the adjusted mean number of steps per day was 3492 (95% CI 2661 4322). By month 5, this had increased to 4502 (36365367) (p=.0007). 28 patients used the tracker at least for 1 month, while 21 (43%) did not. Being bothered by symptoms was the only patient variable that was significantly associated with use of the FitBit®. Those who used the tracker tended to be younger, heavier, more active, and were more likely to have diabetes.
CONCLUSIONS: In the Veteran population, the use of a monitored step tracking device such as the FitBit® is a potentially effective strategy to improve walking distance in claudicators particularly in those with mild symptoms. Additional investigation is needed to determine which patients will benefit most from this walking protocol.

KEY WORDS: Arterial occlusive disease - Exercise - Claudication - Tracking device

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Publication History

Article first published online: January 23, 2018
Manuscript accepted: January 23, 2018
Manuscript revised: December 4, 2017
Manuscript received: May 7, 2017

Cite this article as

Endicott KM, Hynes CF, Amdur R, Macsata R. A modified activity protocol for claudication. J Cardiovasc Surg 2018 Jan 23. DOI: 10.23736/S0021-9509.18.10021-8

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