PMID- 34082001 OWN - NLM STAT- MEDLINE DCOM- 20211220 LR - 20221202 IS - 1097-6809 (Electronic) IS - 0741-5214 (Print) IS - 0741-5214 (Linking) VI - 74 IP - 6 DP - 2021 Dec TI - Claudicating patients with peripheral artery disease have meaningful improvement in walking speed after supervised exercise therapy. PG - 1987-1995 LID - S0741-5214(21)00836-3 [pii] LID - 10.1016/j.jvs.2021.04.069 [doi] AB - OBJECTIVE: Supervised exercise therapy (SET) is a first-line treatment for patients with peripheral artery disease (PAD). The efficacy of SET is most commonly expressed by significant statistical improvement of parameters that do not clarify how each individual patient will benefit from SET. This study examined the minimal clinically important difference (MCID) in walking speed in claudicating patients with PAD after SET. METHODS: A total of 63 patients with PAD-related claudication (Fontaine stage II PAD) participated in a 6-month SET program. Self-selected walking speed was measured before and after SET. Distribution and anchor-based approaches were used to estimate the MCID for small and substantial improvement. The ability to walk one block and the ability to climb one flight of stairs questions were chosen as anchor questions from the Medical Outcomes Study 36-item Short Form questionnaire. Receiver operating characteristics curve analyses were performed to detect the threshold for MCID in walking speed after treatment. RESULTS: The distribution-based method estimated 0.03 m/s as a small improvement and 0.08 m/s as a substantial improvement after SET. Small and substantial improvements according to the anchor question walking one block were 0.05 m/s and 0.15 m/s, respectively. For the climbing one flight of stairs anchor question, 0.10 m/s was a small improvement. Receiver operating characteristics curve analyses identified an increase of 0.04 m/s and 0.03 m/s for improvement based on walking one block and climbing one flight of stairs, respectively. CONCLUSIONS: We report our findings for the MCID for walking speed among claudicating patients receiving SET. Claudicating patients who increase walking speed of 0.03 m/s or greater are more likely to experience a meaningful improvement in walking impairment than those who do not. The MCID reported in this study can serve as a benchmark for clinicians to develop goals and interpret clinically meaningful progress in the care of claudicating patients with PAD. CI - Copyright (c) 2021 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. FAU - Rahman, Hafizur AU - Rahman H AD - Department of Biomechanics, University of Nebraska at Omaha, Omaha, Neb; Department of Surgery and Research Service, Veterans' Affairs Medical Center of Nebraska and Western Iowa, Omaha, Neb. Electronic address: hrahman@unomaha.edu. FAU - Pipinos, Iraklis I AU - Pipinos II AD - Department of Surgery and Research Service, Veterans' Affairs Medical Center of Nebraska and Western Iowa, Omaha, Neb; Department of Surgery, University of Nebraska Medical Center, Omaha, Neb. FAU - Johanning, Jason M AU - Johanning JM AD - Department of Surgery and Research Service, Veterans' Affairs Medical Center of Nebraska and Western Iowa, Omaha, Neb; Department of Surgery, University of Nebraska Medical Center, Omaha, Neb. FAU - Casale, George AU - Casale G AD - Department of Surgery, University of Nebraska Medical Center, Omaha, Neb. FAU - Williams, Mark A AU - Williams MA AD - Department of Medicine, Creighton University School of Medicine, Omaha, Neb. FAU - Thompson, Jonathan R AU - Thompson JR AD - Department of Surgery, University of Nebraska Medical Center, Omaha, Neb. FAU - O'Neill-Castro, Yohanis AU - O'Neill-Castro Y AD - Department of Surgery, University of Nebraska Medical Center, Omaha, Neb. FAU - Myers, Sara A AU - Myers SA AD - Department of Biomechanics, University of Nebraska at Omaha, Omaha, Neb; Department of Surgery and Research Service, Veterans' Affairs Medical Center of Nebraska and Western Iowa, Omaha, Neb. LA - eng GR - I01 RX003266/RX/RRD VA/United States GR - I01 RX000604/RX/RRD VA/United States GR - R01 AG049868/AG/NIA NIH HHS/United States GR - R01 AG034995/AG/NIA NIH HHS/United States GR - R01 HD090333/HD/NICHD NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, U.S. Gov't, Non-P.H.S. DEP - 20210531 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM MH - Aged MH - *Exercise Therapy MH - Functional Status MH - Humans MH - Intermittent Claudication/diagnosis/physiopathology/*therapy MH - Longitudinal Studies MH - Male MH - Middle Aged MH - Minimal Clinically Important Difference MH - Peripheral Arterial Disease/diagnosis/physiopathology/*therapy MH - Recovery of Function MH - Retrospective Studies MH - Time Factors MH - Treatment Outcome MH - Walk Test MH - *Walking Speed PMC - PMC8612940 MID - NIHMS1709961 OTO - NOTNLM OT - Minimal clinically important difference OT - Peripheral artery disease OT - Supervised exercise therapy OT - Walking speed EDAT- 2021/06/04 06:00 MHDA- 2021/12/21 06:00 PMCR- 2022/12/01 CRDT- 2021/06/03 20:14 PHST- 2020/11/23 00:00 [received] PHST- 2021/04/23 00:00 [accepted] PHST- 2021/06/04 06:00 [pubmed] PHST- 2021/12/21 06:00 [medline] PHST- 2021/06/03 20:14 [entrez] PHST- 2022/12/01 00:00 [pmc-release] AID - S0741-5214(21)00836-3 [pii] AID - 10.1016/j.jvs.2021.04.069 [doi] PST - ppublish SO - J Vasc Surg. 2021 Dec;74(6):1987-1995. doi: 10.1016/j.jvs.2021.04.069. Epub 2021 May 31.