Peripheral Artery Disease: Can You Walk Your Way to Better Mobility?

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If you have peripheral artery disease (PAD) you know all about the pain that can come even from just a short walk. But a simple treatment — supervised exercise — may help you walk a lot farther with less pain.

PAD occurs when arteries in your legs become blocked with plaque. As it progresses, pain can occur when you walk, dramatically reducing your mobility.

Avoiding surgery by walking

For years, doctors have recommended walking therapy for those with PAD. This spring, the treatment got the go-ahead for reimbursement under Medicare, making it available to more people.

Doctors typically prescribe supervised exercise and medication to treat PAD initially. Research shows that it may help you avoid more invasive treatments.

A recent study analyzed 25 clinical trials on supervised walking therapy. It found that total and pain-free walking distances improved for those taking part in the therapy.

Nearly three-quarters of the trials reported a 50 percent improvement in walking distance and 5 percent saw a 100 percent improvement. People taking cilostazol, a drug that helps improve blood flow, typically saw a 25 percent to 40 percent improvement in walking distance.

Researchers also find that supervised walking may be as or even more effective than leg stents or bypass surgery for many who have PAD. And, a supervised walking regimen also may benefit those recovering from leg stents or bypass surgery.

What to expect from walking therapy

In supervised therapy, you likely will attend three weekly sessions, walking for 30 minutes to an hour, often on a treadmill. Medical staff will supervise you through alternating periods of exercise and rest.

Cardiologist and vascular medicine specialist  Heather Gornik, MD, Medical Director of Cleveland Clinic’s Non-Invasive Vascular Laboratory, says it’s unclear exactly why this therapy works so well. She suggests these possibilities:

Can you go it alone?

With Medicare now approving this treatment, it is hopefull that supervised therapy will spread quickly in cardiac rehabilitation facilities nationwide, Dr. Gornik says. If you have PAD, ask your doctor or rehab facility about a supervised exercise regimen.

Dr. Gornik says you can start your own exercise regimen similar to those with supervision. Be sure to ask your doctor whether starting a walking regimen on your own is right for you.

If your doctor gives you the green light, here’s what to do:

  1. Walk until your pain intensity is about  3 or 4 out of 5 on a pain scale.
  2. At that point, stop and rest until the pain fades.
  3. Then start walking again.
  4. Your goal is to work up your endurance until you can walk continuously for at least 30 minutes.

Self-starter programs are often less effective than supervised ones, Dr. Gornik says. That is likely because most people have a hard time walking while experiencing pain, she says.

“It really gets a patient over the hump when they’re told, ‘I know it hurts and that’s expected’,” she says. “Having someone pushing them and seeing progress in a safe setting can really help with compliance.”

Supervised or on your own, making time for exercise and staying with it may help you walk farther with less pain if you have PAD.

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