CONTACTS
SUBJECTS
Home Walking Program Resolve Clogged Arteries Recover Peripheral Art
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0503 - ..
0504 - Summary/Objective
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050501 - Follow up ref SDS 3 0000.
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050505 - ..
0506 -
0507 -
0508 - Progress
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050901 - Internet article published by Reuters...
050902 -
050903 - 1. Reuters
050905 - ..
050906 - Home walking program may help clogged leg arteries
050907 -
050908 - http://www.reuters.com/article/2014/05/26/us-home-exercise-artery-disease-idUSKBN0E61IN20140526
050909 -
050910 - BY KRYSTNELL STORR
050912 - ..
050913 - May 26, 2014 1:27pm EDT
050914 -
050915 - 1. (Reuters Health) - People with poor circulation in their
050916 - legs benefit from a home-based walking program and are
050917 - more likely to keep it up over the long term, according to
050918 - a new U.S. study.
050920 - ..
050921 - 2. Researchers say the home-based program may be more
050922 - effective at keeping people motivated than hospital-based
050923 - exercise for a common and disabling problem, and may be a
050924 - more cost-effective first-line treatment.
050926 - ..
050927 - 3. "I was somewhat surprised that we achieved our results of a
050928 - continued difference between the intervention and control
050929 - groups because it is very difficult to get patients to
050930 - adhere to an exercise program long term even when it is
050931 - supervised, and our program was unsupervised," said Dr.
050932 - Mary McDermott, who led the research.
050934 - ..
050935 - 4. According to the National Institutes of Health, eight to
050936 - 12 million people or one in every 20 Americans over the
050937 - age of 50 has peripheral artery disease, or PAD, a
050938 - condition caused by plaque build-up in arteries,
050939 - especially in the legs.
050941 - ..
050942 - Plaque build-up in the arteries causes atherosclerois that blocks
050943 - blood flow, as found during angiogram procedure reporting 3 blockages
050944 - on 091021 0716. ref SDS 2 7L43
050946 - ..
050947 - Research found atherosclerosis plaque build-up occurs from LDL-P
050948 - particles rising above critical level, reported on 131125 0005.
050949 - ref SDS 3 8T5H The danger level seems to be 1300 shown in the lab on
050950 - 140514 0950, ref SDS 4 U45J Being overweight particularly around the
050951 - waist, commonly called metabolic syndrom compounds plaque build up,
050952 - reported on 131125 0005, ref SDS 3 666G, and occurs when triglycerides
050953 - exceed critical levels,
050955 - ..
050956 - Article continues...
050957 -
050958 - 5. Having PAD significantly raises the chances of heart
050959 - attack or stroke.
050961 - ..
050962 - 6. McDermott, a physician and professor at Northwestern
050963 - University in Chicago told Reuters Health, "Symptoms of
050964 - peripheral artery disease are often not classic. A patient
050965 - might just experience weakness in their legs or tiredness
050966 - and both the doctor and the patient might think that it?s
050967 - just a part of aging.?
050969 - ..
050970 - 7. While African Americans are twice as likely as whites to
050971 - develop the disease, other high risk groups include
050972 - smokers, diabetics, people with hypertension or high
050973 - cholesterol and anyone who has had a heart attack or
050974 - stroke.
050976 - ..
050977 - 8. There are few treatments for PAD ? implanted stents to
050978 - open the arteries or medication ? and exercise. Past
050979 - research has shown that treadmill walking can improve
050980 - blood flow and help people with PAD to build up their
050981 - endurance. But those studies focused on programs that
050982 - required patients to go to a hospital or clinic to
050983 - exercise, according to McDermott and her colleagues.
050985 - ..
050986 - 9. They wanted to see if a home-based program might improve
050987 - motivation to exercise by lessening the burden of traveling
050988 - to a medical center three times a week for supervised
050989 - workouts.
050991 - ..
050992 - 10. The researchers recruited 194 participants with clogged
050993 - arteries in their legs and randomly assigned them to two
050994 - groups for the year-long experiment. One group took part in
050995 - a structured home-based exercise program, and the
050996 - comparison group did not exercise.
050998 - ..
050999 - 11. Every participant took a six-minute test at the beginning
051000 - of the study period and again at the end to measure how
051001 - quickly they could pace back and forth along a 100-foot
051002 - hallway.
051004 - ..
051005 - 12. For six months, the home-based exercise group met once a
051006 - week at an exercise center to receive instructions and
051007 - guidance on exercise they?d do at home once a day.
051009 - ..
051010 - 13. Those assigned to the comparison group also met weekly but
051011 - at a medical center and instead of exercise instruction,
051012 - they received health lectures.
051014 - ..
051015 - 14. For the second six months of the study, members of the
051016 - exercise group got a monthly telephone call from their
051017 - group facilitator. They were encouraged to push themselves
051018 - by walking five times a week, taking a quick rest when they
051019 - experienced discomfort, slowly building their way up to a
051020 - 50-minute walk.
051022 - ..
051023 - 15. Members of the comparison group were contacted by a study
051024 - coordinator who went over information related to the health
051025 - topics in the lectures.
051027 - ..
051028 - 16. At the end of the study, people in the exercise program
051029 - walked faster and farther than those in the comparison
051030 - group, whose members ended up performing worse than when
051031 - they started, McDermott?s team reports in the Journal of
051032 - the American Heart Association.
051034 - ..
051035 - 17. The exercise group improved their six-minute walking
051036 - distance by 87 feet, from 1166.0 ft. at the beginning of
051037 - the study period to 1253 ft. at the end. Those in the
051038 - comparison group, on average, walked a distance 25 ft less
051039 - than they had a year earlier.
051041 - ..
051042 - 18. McDermott thinks that even more than the monthly
051043 - motivational phone calls, developing the habit of walking
051044 - for a set amount of time every day probably had the
051045 - strongest effect in the exercise group. She believes that
051046 - continuing the on-site training for a bit longer or
051047 - instituting ways for the participants to benefit from group
051048 - support might have resulted in even greater improvement.
051049 -
051050 - 19. "Some of the participants truly bonded with each other and
051051 - became very engaged in the exercise," McDermott said.
051053 - ..
051054 - 20. Robert Patterson, a physician and clinical researcher at
051055 - Brown University, told Reuters Health that exercise, which
051056 - is considered a more conservative approach to managing
051057 - peripheral artery disease, should be the first prescription
051058 - PAD patients receive.
051060 - ..
051061 - 21. "There are too many people getting what I consider
051062 - unnecessary stenting or too much stenting,? Patterson said.
051063 - ?They come in, they complain, they get a stent that they
051064 - will have for life." If a patient tries exercise first and
051065 - doesn?t see substantial results, they should then turn to
051066 - the more aggressive approach of stenting, he said.
051068 - ..
051069 - 22. "I ask my patients to set aside 40 minutes every day to
051070 - walk. When they first start I tell them they might walk 15
051071 - minutes and rest 25 minutes. After six or 12 weeks, they
051072 - might be walking for 25 minutes and resting for only 15,
051073 - the effects (of walking) can be dramatic," he said.
051075 - ..
051076 - 23. If insurers were to get on board, Patterson adds, it would
051077 - cost the whole healthcare system less money and possibly
051078 - reduce the complications associated with people who get
051079 - stents and must constantly have those stents replaced.
051081 - ..
051082 - 24. "This study is important. This kind of paper gets at the
051083 - issue of how we provide this kind of long lasting improved
051084 - performance to patients in a cost effective fashion," he
051085 - said.
051087 - ..
051088 - Return customers for stent replacements was very evident while waiting
051089 - throughout the day for angiogram procedure at VA Medical Center in San
051090 - Francisco, reported on 091020 0700. ref SDS 1 U59M
051092 - ..
051093 - People who need rest after walking 15 minutes, recommended in the
051094 - article, per above, ref SDS 0 VT4M, typically will have rapid increase
051095 - in performance to walking 50 - 60 minutes without stopping, within 2 -
051096 - 4 weeks, if they go out 3 - 6 times a week. After conditioning has
051097 - improved to the point of walking 50 minutes to reach about 15 miles
051098 - per week, further improvement will occur over a longer time span, but
051099 - this level of exercise will maintain in many cases healthy
051100 - cardiovascular function, noticable in rising HDL, lower tryglycerides,
051101 - and lower LDL-P, especially provided diet is controlled to compliment
051102 - exercise for weight loss. Hiking longer and faster occurring
051103 - naturally from better condition may then cause regression of
051104 - atherosclerosis plaque, as HDL and EPC continue to rise with exercise.
051106 - ..
051107 - Article concludes...
051108 -
051109 - 25. SOURCE: bit.ly/1k8Mi9b Journal of the American Heart
051110 - Association, May 21, 2014.
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