ASSOCIATION BETWEEN MEETING DAILY STEP COUNT GOALS WITH AMBULATORY FUNCTION AND QUALITY OF LIFE IN PATIENTS WITH CLAUDICATION.

OBJECTIVES: To determine (a) whether patients with peripheral artery disease (PAD) who walked at least 7,000 and 10,000 steps/day had better ambulatory function and health-related quality of life (HRQoL) than patients who walked less than 7,000 steps/day, and (b) whether differences in ambulatory function and HRQoL in patients grouped according to these daily step count criteria persisted after adjusting for covariates.

METHODS: Two hundred forty-eight patients were assessed on their daily ambulatory activity for one week with a step activity monitor, and were grouped according to daily step count targets. Patients who took fewer than 7,000 steps/day were included in Group 1 (n=153), those who took 7,000 to 9,999 steps/day were included in Group 2 (n=57), and patients who took at least 10,000 steps/day were included in Group 3 (n=38). Primary outcomes were 6-minute walk distance (6MWD) and Walking Impairment Questionnaire (WIQ) distance score, which is a disease-specific measurement of HRQoL. Patients were further characterized on demographic variables, comorbid conditions, and cardiovascular risk factors.

RESULTS: The groups were significantly different on ankle/brachial index (p=0.02), and on prevalence of hypertension (p=0.04), diabetes (p<0.01), abdominal obesity (p<0.01), arthritis (p=0.04), and chronic obstructive pulmonary disease (p<0.01). Thus, these variables served as covariates in adjusted analyses, along with age, weight, and sex. 6MWD (mean±SD) was significantly different among the groups in unadjusted (p<0.01) and adjusted (p<0.01) analyses (Group 1=313±90 m, Group 2=378±84 m, Group 3=414±77 m), with Groups 2 and 3 having higher 6MWD than Group 1 (p<0.01). WIQ distance score was significantly different among the groups in unadjusted (p<0.01) and adjusted (p<0.01) analyses (Group 1=30±30%, Group 2=45±35%, Group 3=47±34%), with Groups 2 and 3 having higher WIQ distance scores than Group 1 (p<0.01).

CONCLUSIONS: PAD patients who walked more than 7,000 and 10,000 steps/day had greater ambulatory function and HRQoL than patients who walked fewer than 7,000 steps/day. Secondly, the greater ambulatory function and HRQoL associated with walking 7,000 and 10,000 steps/day persisted after adjusting for covariates. This study provides preliminary evidence that PAD patients who walk more than 7,000 steps/day have better ambulatory function and HRQoL than patients below this threshold.