Don’t stop walking: the in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic

• Published in: Internal and emergency medicine Vol. 16; no. 5; pp. 1307 - 1315
• Main Authors: Lamberti, Nicola, Straudi, Sofia, Manfredini, Roberto, De Giorgi, Alfredo, Gasbarro, Vincenzo, Zamboni, Paolo, Manfredini, Fabio
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.08.2021; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Ankle; Blood pressure; Body weight; Chi-Square Distribution; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - physiopathology; COVID-19 - therapy; COVID-19 : diagnosis; EM - Original; Exercise Therapy - methods; Exercise Therapy - statistics & numerical data; Female; Home Care Services - standards; Home Care Services - statistics & numerical data; Humans; Internal Medicine; Interviews as Topic; Male; management and prognosis; Medicine; Medicine & Public Health; Middle Aged; Mobility; Pain; Pandemics; Patients; Peripheral Arterial Disease - complications; Peripheral Arterial Disease - therapy; Rehabilitation; Rehabilitation - methods; Rehabilitation - statistics & numerical data; Risk factors; Severe acute respiratory syndrome coronavirus 2; Statistics, Nonparametric; Surveys and Questionnaires; Vascular diseases; Walking; Walking - physiology; Walking - statistics & numerical data; Peripheral artery disease; Mobility; Exercise; Rehabilitation; Cardiovascular diseases; Risk factors
• DOI: 10.1007/s11739-020-02598-4
• ISSN: 1828-0447; 1970-9366

We studied the outcomes of peripheral artery disease (PAD) patients enrolled in a structured in-home walking program right before the lockdown due to the SARS-CoV-2 epidemic emergency, to determine whether this intervention ensured the maintenance of mobility even in the case of movement restrictions. We selectively studied 83 patients (age 72 ± 11, males n  = 65) enrolled in the program within 9-month before the lockdown. The usual intervention was based on two daily 8-min sessions of slow intermittent in-home walking prescribed in circa-monthly hospital visits. During the lockdown, the program was updated by phone. Six-minute (6MWD) and pain-free walking distance (PFWD) were measured pre- and post-lockdown as well as body weight (BW), blood pressure (BP), and ankle-brachial index (ABI). Sixty-six patients were measured 117 ± 23 days after their previous visit. A safe, pain-free execution of the prescribed sessions was reported (median distance: 74 km). Overall, the 6MWD was stable, while PFWD improved ( p  < 0.001). The improvement was not related to age/gender, comorbidities, type of home but to the time of enrollment before lockdown. The new-entry subjects (≤ 3 months; n  = 35) obtained significant improvements post-lockdown for 6MWD and PFWD, while those previously enrolled (> 3 months; n  = 31) were stable. Decreased BW with stable BP and ABI values were also recorded, with better outcomes for new-entry subjects. In PAD patients, a structured walking program performed inside home and purposely guided by phone was adhered to by patients and favored mobility and risk factor control during the COVID-19 pandemic, regardless of walking ability, type of home and external conditions.