Effect of structured home-based exercise on walking ability in patients with peripheral arterial disease: a meta-analysis

Abstract

Background: The present study is designed to investigate the effect of structured home-based exercise (SHE) programs on maximal walking time (MWT), pain-free walking time (PFWT), and self-reported walking ability in patients with peripheral arterial disease (PAD).

Methods: We searched the databases including MEDLINE, EMBASE, ISI Web of Knowledge, and the Cochrane Library from inception to December 2013 for randomized controlled trials (RCTs) that assessed the effect of SHE programs on walking ability in patients with PAD. Meta-analysis was performed based on the searched results, moreover, we made a systemic review regarding the results along with our knowledge.

Results: Of all the 348 publications we got from the databases, 5 RCTs covering 547 patients reached the inclusion criteria and were involved in the present study. Both inverse-variance fixed-effects and random-effects model were used to perform meta-analysis. SHE programs improved MWT by mean difference of 66.78 sec (95% confidence interval [CI], 5.15-128.41; P = 0.03), heterogeneity across studies was significant. When the trial accounting for significant heterogeneity was omitted, SHE programs improved MWT by mean difference of 91.21 sec (95% CI, 51.96-130.45; P < 0.0001). In contrast, there was no significant heterogeneity across the studies with regard to PFWT and Walking Impairment Questionnaire (WIQ) score. SHE programs improved both PFWT and WIQ scores (mean difference of PFWT, 57.76s; 95% CI, 20.42-95.10; P = 0.002; mean difference of WIQ distance score, 8.67; 95% CI, 3.86-13.49; P = 0.0004; mean difference of WIQ speed score, 8.05, 95% CI, 4.46-11.64; P < 0.0001; mean difference of WIQ stair-climbing score, 6.44; 95% CI, 2.55-10.34; P = 0.001).

Conclusions: SHE programs improve walking ability in patients with PAD.