Exercise Modality and Supervised Exercise Therapy Outcomes for Peripheral Artery Disease: A 5-Year Retrospective Chart Review

PURPOSE: Centers for Medicare and Medicaid Services-reimbursed clinical supervised exercise therapy (SET) programs for the treatment of peripheral artery disease (PAD) are in their infancy. This study evaluated the clinical effectiveness of guideline-directed exercise prescription that reflects current recommendations in SET and the influence of exercise modality on outcomes. METHODS: A retrospective chart review of patients with PAD enrolled in a Midwest clinical SET program between October 1, 2017 and December 31, 2022 was conducted. Patient demographic and medical characteristics, SET participation (including exercise modality, number of sessions completed, and attrition), and outcomes (6-minute walk test distance and Vascular Quality of Life Questionnaire-6) were abstracted. Outcomes were evaluated overall and by exercise modality (ie, treadmill only, total body recumbent stepping, and multimodality aerobic exercise). RESULTS: Four hundred patients with PAD completed ≥1 SET session during this period and were included in the present study. The enrolled sample was 88% non-Hispanic White, 39% female, and had a mean age of 71.2 ± 9.6 years and a mean ankle brachial index of 0.67 ± 0.23. Participants attended 17.6 (50%) of 36 sessions. Attendance ( P = .52) and attrition ( P = .15) were not significantly different among modalities. All groups experienced significantly increased 6-minute walk test distance (53.5 ± 4.5 m; P < .01) and Vascular Quality of Life Questionnaire-6 (3.03 ± 0.31, P < .01); baseline-adjusted between-group differences were not significant ( P = .77 and P = .80, respectively). CONCLUSIONS: Clinically implemented SET programs that follow current guidelines for exercise prescription improve walking capacity and quality of life in persons with symptomatic PAD. This study represents the first steps in the generation of program benchmarks for clinical SET programs.