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  • 1
    Online Resource
    Online Resource
    Implementation of Supervised Exercise Therapy for Patients With Symptomatic Peripheral Artery Disease: A Science Advisory From the American Heart Association
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Circulation Vol. 140, No. 13 ( 2019-09-24)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 140, No. 13 ( 2019-09-24)
    Abstract: Patients with lower-extremity peripheral artery disease (PAD) have greater functional impairment, faster functional decline, increased rates of mobility loss, and poorer quality of life than people without PAD. Supervised exercise therapy (SET) improves walking ability, overall functional status, and health-related quality of life in patients with symptomatic PAD. In 2017, the Centers for Medicare & Medicaid Services released a National Coverage Determination (CAG-00449N) for SET programs for patients with symptomatic PAD. This advisory provides a practical guide for delivering SET programs to patients with PAD according to Centers for Medicare & Medicaid Services criteria. It summarizes the Centers for Medicare & Medicaid Services process and requirements for referral and coverage of SET and provides guidance on how to implement SET for patients with PAD, including the SET protocol, options for outcome measurement, and transition to home-based exercise. This advisory is based on the guidelines established by the Centers for Medicare & Medicaid Services for Medicare beneficiaries in the United States and is intended to assist clinicians and administrators who are implementing SET programs for patients with PAD.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIR.0000000000000727
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 1466401-X
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  • 2
    Online Resource
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    Total body recumbent stepping vs treadmill walking in supervised exercise therapy: A pilot study
    SAGE Publications ; 2022
    In:  Vascular Medicine Vol. 27, No. 2 ( 2022-04), p. 150-157
    Details
    In: Vascular Medicine, SAGE Publications, Vol. 27, No. 2 ( 2022-04), p. 150-157
    Abstract: Background: Treadmill walking is the most commonly recommended exercise modality in supervised exercise therapy (SET) for peripheral artery disease (PAD); however, other modalities may be equally effective and more tolerable for patients. The primary aim of this single-blind, randomized pilot study was to compare the feasibility, safety, and preliminary efficacy of a treadmill walking (TM) versus a total body recumbent stepping (TBRS) exercise program for treatment of PAD (i.e., "Stepper Study").. Methods: Participants ( n = 19) enrolled in a 12-week SET program and were randomized to either a TM ( n = 9) or TBRS ( n = 10) exercise group that followed current SET exercise guidelines. Feasibility, safety, and efficacy outcomes were assessed. Results: SET attendance was 86% and 71%, respectively, for TBRS and TM groups ( p = 0.07). Session exercise dose (metabolic equivalents of task [MET] minutes) (mean [SD] ) for TM was 117.6 [27.4] compared to 144.7 [28.7] in the TBRS group ( p = 0.08). Study-related adverse events were nine in 236 training hours and three in 180 training hours for the TBRS and TM groups, respectively. There were no significant differences between groups for improvement in 6-minute walk distance (mean [SD]) (TM: 133.2 ft [53.5] vs TBRS: 154.8 ft [49.8]; p = 0.77) after adjusting for baseline 6-minute walk distance. Conclusion: This is the first randomized study comparing TBRS to TM exercise in SET using current SET guidelines. This pilot study showed that TBRS is a feasible and safe exercise modality in SET. This study provides preliminary efficacy of the use of TBRS exercise in SET programs following current guidelines. Larger studies should be conducted to confirm these findings.
    Type of Medium: Online Resource
    ISSN: 1358-863X , 1477-0377
    URL: Article
    DOI: 10.1177/1358863X211068888
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2027562-6
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  • 3
    Online Resource
    Online Resource
    A Comparison of Cardiopulmonary Exercise Testing and Field Walking Tests in Community-Dwelling Older Adults With Mild-to-Moderate Alzheimer’s Dementia
    Human Kinetics ; 2020
    In:  Journal of Aging and Physical Activity Vol. 28, No. 6 ( 2020-12-1), p. 911-919
    Details
    In: Journal of Aging and Physical Activity, Human Kinetics, Vol. 28, No. 6 ( 2020-12-1), p. 911-919
    Abstract: The purpose of this study was to investigate the relationships among peak exercise parameters on 6-min walk test, shuttle walk test, and laboratory-based cardiopulmonary exercise testing in persons with Alzheimer’s dementia. This study is a cross-sectional analysis of the baseline data of 90 participants (age 77.1 [6.6] years, 43% female) from the FIT-AD trial. Cardiopulmonary exercise testing produced significantly higher peak heart rate (118.6 [17.5] vs. 106 [22.8] vs. 106 [18.8]  beats/min), rating of perceived exertion (16 [2.1] vs. 12 [2.3] vs. 11 [2.1]), and systolic blood pressure (182 [23.7] vs. 156 [18.9] vs. 150 [16.9]  mmHg) compared with the shuttle walk test and 6-min walk test, respectively. Peak walking distance on shuttle walk test (241.3 [127.3] m) and 6-min walk test (365.0 [107.9]  m) significantly correlated with peak oxygen consumption (17.1 [4.3] ml·kg −1 ·min −1 ) on cardiopulmonary exercise testing ( r  = .449, p  ≤ .001 and r  = .435, p  ≤ .001), respectively, which is considerably lower than what is seen in older adults and persons with cardiopulmonary diseases.
    Type of Medium: Online Resource
    ISSN: 1063-8652 , 1543-267X
    URL: Article
    DOI: 10.1123/japa.2019-0387
    Language: Unknown
    Publisher: Human Kinetics
    Publication Date: 2020
    SSG: 31
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  • 4
    Online Resource
    Online Resource
    RELATIONSHIP OF CARDIOPULMONARY EXERCISE TESTING AND FIELD WALKING TESTS IN MILD-MODERATE ALZHEIMER’S DEMENTIA
    Oxford University Press (OUP) ; 2019
    In:  Innovation in Aging Vol. 3, No. Supplement_1 ( 2019-11-08), p. S611-S611
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 3, No. Supplement_1 ( 2019-11-08), p. S611-S611
    Abstract: The purpose of this study was to investigate relationships among peak exercise parameters on 6-minute walk (6MWT) and shuttle walk tests (SWT), and laboratory-based cardiopulmonary exercise testing (CPET). These relationships have been established in cardiopulmonary patient populations, but not in community-dwelling older adults with mild-moderate Alzheimer’s dementia (AD). This study is a cross-sectional analysis of the baseline data of 6MWT, SWT, and CPET from the FIT-AD Trial (n=88: 49 males [76.6 {7.0} years and MMSE 21.5{3.5}] and 39 females [77.3 {6.5} years and MMSE 22.1 {3.4}] ). Peak values for each test included heart rate (HR), systolic blood pressure (SBP), and rating of perceived exertion (RPE). Peak oxygen assumption (VO2) was measured in the CPET. Peak walking distance (PWD) was measured for the 6MWT and SWT. CPET produced significantly higher peak HR (118.7 [17.5] vs. 106 [22.8] vs. 106 [18.8] bpm), RPE (16 [2.1] vs. 12 [2.3] vs. 11 [2.1] ) and SBP (182 [23.7] vs. 156 [18.9] vs. 150 [16.9] mmHg) compared to the SWT and 6MWT respectively. PWD on SWT (240.4 [128.1] m) and 6MWT (364.3 [108.5] m) significantly correlated with peak VO2 (17.0 [4.3] ml/kg/min) on CPET (r=.44 and r=.43) respectively. Correlations of peak VO2 and PWD on SWT in persons with AD are considerably lower than what is seen for persons with cardiopulmonary diseases. This lower correlation seen in our sample may be due to shorter PWD on walking tests. Future research should focus how mobility affects correlation of peak values on these tests.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igz038.2275
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2905697-4
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  • 5
    Online Resource
    Online Resource
    Clinical Effectiveness of a Supervised Exercise Therapy Program for Treatment of Peripheral Artery Disease: A Translational Study
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Journal of Cardiopulmonary Rehabilitation and Prevention Vol. 43, No. 5 ( 2023-09), p. 361-367
    Details
    In: Journal of Cardiopulmonary Rehabilitation and Prevention, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. 5 ( 2023-09), p. 361-367
    Abstract: National guidelines for the treatment and management of symptomatic peripheral artery disease (PAD) recommend supervised exercise therapy (SET) as a first line of therapy. However, it is unknown how these expert opinion–based SET guidelines work in clinical practice as SET programs become established following the 2017 Centers for Medicare & Medicaid Services coverage announcement. The purpose of this prospective, nonrandomized translational study was to evaluate the clinical effectiveness of a SET program and specifically walking exercise modalities that did not incorporate a treadmill (TM). Methods: Participants enrolled in a 12-wk SET program housed in four rural Midwest cardiac rehabilitation settings and were prescribed an exercise program by an exercise physiologist or nurse based on current SET guidelines. Groups included TM walking, total body recumbent stepping (TBRS), TM walking + TBRS, and multimodal. Pre- and post-tests of walking capacity, physical function, and quality of life were administered. Results: The sample (n = 93) was all White, with 55% female representation, age of 73.7 ± 9.0 yr, and mild-moderate PAD (ankle-brachial index = 0.71 ± 0.19). Collectively, SET significantly improved the 6-min walk test (32.1 ± 6.6 m; P 〈 .01). Within-group changes in the 6-min walk test were seen for all groups except the multimodal group; there were no significant between-group differences in change scores ( P = .30). No significant between-group changes were seen for the TM walking, TBRS, and TM walking + TBRS groups for physical function measures. Conclusion: This study demonstrates the clinical effectiveness of SET programs following current guidelines and potential utilization of non-TM walking modalities in SET programs.
    Type of Medium: Online Resource
    ISSN: 1932-7501
    URL: Article
    DOI: 10.1097/HCR.0000000000000790
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2271356-6
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  • 6
    Online Resource
    Online Resource
    Aerobic Exercise, Training Dose, and Cardiorespiratory Fitness: Effects and Relationships with Resting Plasma Neurotrophic Factors in Alzheimer’s Dementia
    MDPI AG ; 2023
    In:  Journal of Vascular Diseases Vol. 2, No. 3 ( 2023-09-01), p. 351-366
    Details
    In: Journal of Vascular Diseases, MDPI AG, Vol. 2, No. 3 ( 2023-09-01), p. 351-366
    Abstract: Background: Vascular health is increasingly recognized for its roles in the pathogenesis and progression of Alzheimer’s disease (AD). The objective of this study was to investigate effects of exercise training, dose, and cardiorespiratory fitness (CRF) on neurotrophic factors in community-dwelling, older adults with mild-to-moderate AD dementia. Methods: This was a pilot blood ancillary study of the FIT-AD trial. Participants in the parent study were randomized to 6-month aerobic exercise (AEx) or stretching control. For this ancillary study, resting plasma brain-derived neurotrophic factor (BDNF), irisin, fibroblast growth factor-21 (FGF-21), and insulin-like growth factor-1 (IGF-1) biomarkers were assessed at baseline, 3, and 6 months. Estimates of within- and between- group effect sizes were calculated (Cohen’s d). Relationships of biomarker change with dose and CRF change were explored with multivariable linear regression and repeated measures correlations. Results: The sample (n = 26, 18 AEx/8 stretching) averaged 77.6 ± 6.9 years old, with the majority being male (65.4%), and non-Hispanic White (92.3%); between-group effect sizes were generally small except for irisin (d = −0.44)), AEx group relative to stretching group. Associations of dose and changes in CRF with changes in neurotrophic biomarker were weak (r2 ≤ 0.025). Conclusions: The effects of exercise on BDNF, irisin, IGF-1, and FGF-21 were heterogeneous in AD. Our findings need validation in future, adequately powered exercise studies in AD.
    Type of Medium: Online Resource
    ISSN: 2813-2475
    URL: Article
    DOI: 10.3390/jvd2030027
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 3136560-7
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  • 7
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    Online Resource
    Relationship Of Cardiorespiratory Fitness And Cognitive Functioning In Persons With Subjective Cognitive Decline : 3128
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Medicine & Science in Sports & Exercise Vol. 55, No. 9S ( 2023-9), p. 1055-1056
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 55, No. 9S ( 2023-9), p. 1055-1056
    Type of Medium: Online Resource
    ISSN: 1530-0315 , 0195-9131
    URL: Article
    DOI: 10.1249/01.mss.0000989680.81127.05
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 8
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    A case study of recumbent cross-training in supervised exercise therapy for peripheral artery disease (PAD)
    Elsevier BV ; 2019
    In:  Journal of Vascular Nursing Vol. 37, No. 3 ( 2019-09), p. 223-224
    Details
    In: Journal of Vascular Nursing, Elsevier BV, Vol. 37, No. 3 ( 2019-09), p. 223-224
    Type of Medium: Online Resource
    ISSN: 1062-0303
    URL: Article
    DOI: 10.1016/j.jvn.2019.09.003
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2048804-X
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  • 9
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    Adherence and exercise mode in supervised exercise therapy for peripheral artery disease
    Elsevier BV ; 2020
    In:  Journal of Vascular Nursing Vol. 38, No. 3 ( 2020-09), p. 108-117
    Details
    In: Journal of Vascular Nursing, Elsevier BV, Vol. 38, No. 3 ( 2020-09), p. 108-117
    Type of Medium: Online Resource
    ISSN: 1062-0303
    URL: Article
    DOI: 10.1016/j.jvn.2020.07.002
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2048804-X
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  • 10
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    Experience Implementing Supervised Exercise Therapy for Peripheral Artery Disease
    Clinical Exercise Physiology Association ; 2019
    In:  Journal of Clinical Exercise Physiology Vol. 8, No. 1 ( 2019-03-01), p. 1-12
    Details
    In: Journal of Clinical Exercise Physiology, Clinical Exercise Physiology Association, Vol. 8, No. 1 ( 2019-03-01), p. 1-12
    Abstract: Background: Supervised exercise therapy (SET) is a cornerstone of treatment for improving walking distance for individuals with symptomatic peripheral artery disease and claudication. High-quality randomized controlled trials have documented the efficacy of SET as a claudication treatment and led to the recent Centers for Medicare and Medicaid decision to cover supervised exercise therapy (SET). However, to date, the translation of highly controlled, laboratory-based SET programs in real-world cardiopulmonary rehabilitation settings has not been explored. Methods: In this article, we described our experience integrating SET into existing cardiopulmonary rehabilitation programs, focusing on patient evaluation, exercise prescription, outcome assessments, strategies to maximize program adherence, and transitioning to home and community-based exercise training. Results: Our team has over 3 years' experience successfully implementing SET in cardiac rehabilitation settings. The experiences communicated here can serve as a model for clinical exercise physiologists as they begin to incorporate SET in their rehabilitation programs. Conclusion: CMS reimbursement has the potential to change clinical practice and utilization of SET for patients with symptomatic peripheral artery disease. The experience we have gained through implementation of SET programs across the M Health and Fairview Health Systems and in other Minnesota communities—including specific elements in our programs and the lessons learned from our clinical experience—can inform and help guide development of new programs.
    Type of Medium: Online Resource
    ISSN: 2165-6193 , 2165-7629
    URL: Article
    DOI: 10.31189/2165-6193-8.1.1
    Language: English
    Publisher: Clinical Exercise Physiology Association
    Publication Date: 2019
    SSG: 31
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