Director of supporting angiology and CV hospitals and operating rooms of CHU Porto and CMIN. UMIB researcher. Invited Associate Professor of ICBAS
Posted on June 22, 2022
Peripheral artery disease (PAD) is a progressive disorder that reduces the patient’s general quality of life. It is expensive for the national health system, but mainly for patients and their families. Physical exercise is a front-line treatment associated with the control of risk factors and has proven to be effective in increasing the distance covered without pain.
Exercise programs in the form of walking should be performed for a minimum of 30-45 minutes per session, 3-4 times a week, for at least 12 weeks.
However, the ongoing personalized program in the hospital context is the lack of space and availability of human resources dedicated to face-to-face rehabilitation therapy, the costs associated with this rehabilitation therapy, the need for travel and labor. Patients due to time incompatibility.
In addition to these factors, there are distance difficulties and impositions caused by the covid-19 pandemic situation that have a strong impact on the functional recovery of these patients. A personalized, supervised physical exercise prescription in the patient’s area overcomes the limitations of a supervised program in the hospital context, as it is inexpensive and has no time limit.
Improving functional capacity and quality of life by minimizing symptoms and reducing vascular morbidity and mortality is the main focus of PAD management.
Studies have demonstrated the lasting benefits of supervised exercise therapy (SET) over simple carry-on advice in patients with intermittent claudication (IC), but it is a tool that has not yet been fully utilized. The SET program is not very successful as it is not readily available in most European countries. Only 30% of vascular surgeons have direct access, inadequate facilities available, and poor patient compliance. Patient restrictions on adherence to exercise are often primarily due to socio-economic restrictions due to lack of transportation and time.
To overcome these problems, Structured Home Exercise Therapy (HBET) with observation components (such as logbooks) and personalized gait-specific advice is an effective alternative when the SET program is not available. Can be provided.
Compliance with physical activity is low, primarily due to lack of motivation, motivation and difficulty associated with poor health, patient choice, and lack of results (Harzand et al., 2020; Harwood et al., 2016). But J. In 2019, Golledge et al published a meta-analysis suggesting that the HBET program, complemented by motivational interventions, significantly improved gait performance and physical activity in PAD patients.
This has been shown to improve the HBET program’s more structured and monitored. Therefore, there is an urgent need to develop strategies to improve the population’s compliance with physical exercise programs and promote behavioral changes (Kim et al., 2021).
M-mHealth technology provides a valuable tool for creating structured and monitored HBET programs. Information and Communication Technology (ICT) tools have already been applied to monitor patients during HBET programs such as Geographic Information Systems (GIS) tools (such as Google Maps). These tools are cheap and easy to use household tools and are widely used. Of availability.
McDermott and colleagues use Google Maps to provide a breakthrough method for objectively measuring patient adherence to exercise plans, providing sufficient accuracy to monitor PAD’s exercise at home. I concluded that I could.
The use of ICT tools for self-monitoring is important for long-term behavioral changes. We believe that the HBET program for PAD patients, supported by mHealth tools to improve behavior change monitoring and compliance, will be effective in the long run.
There are very few studies investigating the use of mHealth, especially in patients with PAD in mobile applications. Even more restricted are the available mobile applications specifically developed for DAPs that facilitate and monitor exercise sessions in the HBET framework.
So far, only two applications have been developed for this purpose (CReTe in Spain, 2014 and JBZetje in the Netherlands, 2021).
Both collect data from exercise sessions such as mileage, number of stops, reasons for stopping, walking time and speed, and give patients access to walking history and progress, both of which route according to the patient’s preference. It cannot be customized. And walking ability.
The WalkingPad program contributes with a set of resources (apps, platforms, virtual assistants) of a cross-disciplinary nature that enable healthcare professionals to promote joint patient responsibility in disease management in a responsible and sustainable manner. Is aimed at. ..
Prescriptions for the WalkingPad program may be part of the prescription menu currently available in the clinical system (Sclinico), along with hospitals within the scope of outpatient care, as well as healthcare and the surrounding community. Active participation in the management of their illness.
The WalkingPad program’s interfaces / resources can be included in a participant’s life in the form of healthy behavior and are therefore sustainable over the long term. It is a tool that can be used by anyone with a low or high level of digital literacy, so it requires a high degree of knowledge and skill as it has no associated costs and has advantages and added value in managing disease. plug. Part of the patient (providing app monitoring and AV motivational components) and healthcare professionals (getting compliance data directly on the consulting platform).
Event on December 24, 2017: