“New physio studies are a step in the right direction for adults with walking difficulties” – Miriam Stoppard

dr Miriam Stoppard looks at a new initiative that could help patients with peripheral artery disease

The study has given sufferers a leap in their step

We all know the mental and physical benefits of walking, and it’s a simple exercise that many of us take for granted. But for some, walking can cause excruciating pain in the calves, making putting one foot in front of the other an ordeal.

This may be due to a condition called intermittent claudication, which is caused by crusted arteries restricting the blood supply to your leg muscles – but a new study has given some sufferers a crack in the crotch.

Adults with this poor circulation in their legs received one-on-one physical therapy sessions aimed at increasing motivation and engagement in the movement — and they were able to keep going.

King’s College London worked with six UK hospitals as part of the MOSAIC study (Motivating Structured Walking Activity in People with Intermittent Claudication). It ran between January 2018 and March 2020 and included 190 adults with peripheral arterial disease (PAD).

PAD is a fairly common condition in which fatty deposits in the arteries block blood flow to the leg muscles. This means that those affected may have limited ability to walk. Supervised exercise therapy is recommended to improve it in people with PAD, but participation rates are low.

This could be due to lack of time, limited transportation to practice sessions, motivation and resources.

The researchers believe that a program led by physical therapists could increase motivation and engagement in at-home gait exercise and improve walking ability. The MOSAIC study divided patients into two groups, with one group receiving usual NHS care and the other receiving one-to-one physical therapy.

Sessions that focused on getting people to walk used behavior modification techniques to help them persevere. They were also given a manual, a pedometer and an exercise diary.

After three months, this group went on to compare their NHS peers in a six-minute timed test. MOSAIC participants were also able to walk 17 meters further in the test and walked 31 seconds longer before experiencing leg pain.

They were also able to perform day-to-day activities better, had more positive views of walking as a treatment modality, and were able to continue exercising after the sessions were completed.

A follow-up six months later also found that they reported major improvements in their ability to walk.

Professor Lindsay Bearne, the study’s lead investigator, says: “Regular exercise is recommended for people with PAD, but supervised exercise sessions are not always available or convenient for participants.

“The MOSAIC program provides an innovative, effective and acceptable treatment that improves outcomes and helps people with this debilitating condition learn how to exercise appropriately and manage their condition on their own.”

What a great initiative.

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