There is some evidence to indicate that the inclusion of wearable activity monitors in home-based exercise therapy improves walking ability and quality of life in patients with intermittent claudication. This is the main finding of a systematic review that recently appeared online in the European Journal of Vascular and Endovascular Surgery (EJVES).
Despite the fact that supervised exercise therapy is the recommended first-line management for intermittent claudication, authors Calvin Chan, BS, a fifth-year medical student at Imperial College London in London and colleagues write that its uptake is “often limited by accessibility, compliance, and cost.”
As a result, they state that there has been an increased interest in the use of wearable activity monitors in home-based telemonitoring exercise program for claudicants. In their review, Chan et al aimed to evaluate the efficacy of wearable activity monitors as a feedback and monitoring tool in home-based exercise program for patients with intermittent claudication.
The investigators searched the MEDLINE, EMBASE and Web of Science databases through to April 2020. They included randomized and prospective trials, which had to incorporate wearable activity monitors as a feedback tool to target walking/exercise behavior. The primary outcome was change in walking ability, measured by maximum walking distance, claudication distance, and six-minute walking distance.
Chan and colleagues report that 1,148 records were retrieved, including eight randomized controlled trials and one prospective cohort study that met the inclusion criteria. The authors note that, due to heterogeneity between the studies, they could not conduct a meta-analysis.
Writing in EJVES, the authors relay that wearable activity monitor interventions improved measures of walking ability, increased daily walking activity, the cardiovascular metric of maximum oxygen consumption, and quality of life.
While Chan and colleagues conclude that this is “some evidence” to support home-based wearable activity monitor interventions are beneficial for improving outcomes for patients with intermittent claudication, they stress that existing studies are limited by inadequate sample size, duration, and appropriate power. “Achieving consensus on outcome reporting and study methods, as well as maximizing device adherence, is needed,” they posit.