Peripheral artery disease (PAD) occurs due to plaque development in the arteries of the legs. It is a highly prevalent public health problem with worldwide prevalence estimated at ~200 million. This inadequate lower extremity blood flow results in exertional ischemic pain called claudication which patients describe as leg pain during physical activity that resolves with rest. Hospital-based supervised exercise training (SET) improves functional ability and quality of life for patients with PAD. However, SET has only recently been approved for reimbursement and both efficacy and key components of the exercise prescription completed by PAD patients–including frequency, intensity, duration, and type of activity–have not been evaluated in real-world clinical settings. In addition, the activity patterns of PAD patients outside of hospital-based SET remains unclear, as most studies have only evaluated ambulatory patterns of PAD patients over short periods of time, using self-report and ambulatory monitoring devices such as pedometers and global-positioning systems (GPS).
This project proposes to combine accelerometer data with contextual activity data collected by Daynamica to measure and describe the physical activity of PAD patients during a 12 week hospital-based SET program. We will use data derived from the Daynamica app to: 1) calculate the dose of physical activity achieved and describe activity patterns of patients within and outside the SET program, 2) determine the effect of enhancements in patient-therapist interactions using the summaries of exercise provided by the Daynamica app, and 3) utilize the experiential knowledge of both PAD patients and providers from the SET program to gain a better understanding of the exercise program and Daynamica app. The project addresses a timely scientific question using advanced sensor technology developed at the University of Minnesota. Results from this study will inform the design of larger studies of SET, and help make future interventions more effective and personalized for those with PAD.