The use of a wearable exercise tracker can improve walking distance and quality of life in patients suffering from intermittent claudication at six months, a study has shown. Results of the randomised wSTEP (Wearable sensor technology efficacy in peripheral vascular disease) trial were presented at the British Society of Endovascular Therapy Annual Meeting (BSET; 2–3 July, Walton Hall, UK).
Patients suffering from claudication have significant walking impairment, reduced quality of life and a higher rate of cardiovascular events, Pasha Normahani, Imperial Vascular Unit, Imperial Academic Health Science Centre, London, UK, told delegates at the BSET Annual Meeting. The lead author of the study is Celia Riga, vascular surgeon and clinical lecturer at Imperial College London. Supervised exercise programmes are effective in improving walking distances; however, he added, patients are often either poorly compliant with these programmes or fail to maintain exercise levels following its completion. Furthermore, these programmes are expensive to run and therefore not available to all patients. “The clinical challenge is to develop a system that minimises the use of healthcare resources while maximising patient motivation,” Normahani said.
The aim of the wSTEP study was to determine whether the use of a wearable activity tracker (Nike+ FuelBand, Nike) improves walking distances and quality of life in patients with intermittent claudication. The Nike+ FuelBand is a wrist-worn activity monitor with an accessible user interface that records number of steps, calories burned and “fuel” points. They also allow for personalised goal setting and give real-time feedback regarding progression towards goal.
This wSTEP study was conducted at St Mary’s Hospital, London, UK, between October 2013 and December 2014. Thirty-seven claudicants were randomly allocated to either the Nike+ FuelBand wearable device (n=20) or control group (n=17). Data were analysed for 18 patients in the wearable device group and 13 patients in the control group. Claudication distance, maximum walking distance, patient reported walking distance and quality of life (VascuQol questionnaire) were measured at baseline, three months and six months. The two groups were well matched for age, sex, smoking status and supervised exercise programme enrolment (Nike+ FuelBand 10.5% vs. control 30%, p=0.32).
At six months patients in the wearable device group made significant improvement in median claudication distance—from 40m at baseline to 115m at six months (p<0.001)—and also significantly higher improvements compared to the control group (63m vs. 10m, p=0.002). In addition, the wearable device group saw significant improvement in maximum walking distance over six months (80m vs. 178m, p<0.001), and had higher improvements than the control group (82m vs. -5m, p=0.01). Patient reported walking distance also significantly improved over six months, from 183m to 370m (p<0.001) and the improvements were higher when compared to the control group (137m vs. 0m, p=0.005).
When the investigators looked at quality of life, the results showed that the wearable device group made significant improvement in the VascuQol score over six months—4.7 vs. 5.6 (p=0.001). As with the previous factors, these improvements were higher than those seen in the control group patients (p=0.031). Patients in the control group demonstrated significant improvement in VascuQol score at six months compared to baseline (4.5 vs 4.7, p= 0.028). However, they did not demonstrate any significant difference in claudication distance (p=0.18), maximum walking distance (p=0.36) or patient reported walking distance (p=0.48).
Normahani concluded that in patients suffering from short distance claudication, the use of wearable activity tracker technology improved claudication distance, maximum walking distance, patient reported walking distance and quality of life to a greater extent than standard conservative therapy and may be used to encourage exercise habits. He added that the potential applications of the device include management of intermittent claudication in the community, and as a supplement or alternative to supervised exercise programmes.
Patients’ feedback:
“The band challenges me to walk more everyday”
“It motivates me to get out of the house”
