OBJECTIVE Determine the efficacy of a home-based walking intervention to improve walking ability and quality of life in people with diabetes and peripheral arterial disease (PAD). RESEARCH DESIGN AND METHODS We conducted a randomized, controlled, single-blind trial within university-affiliated clinics in our local community. We randomized 145 participants (45 women) with diabetes and PAD to our intervention-a 6-month behavioral intervention targeting levels of readiness to engage in routine walking for exercise-versus attention control. Our primary outcome was 6-month change in maximal treadmill walking distance. Secondary outcomes included 3-month change in maximal walking distance, lower limb function (ie, walking impairment scores), quality of life (Medical Outcomes Short Form Survey), exercise behaviors, depressive symptoms, and self-efficacy at 3 and 6 months. RESULTS The mean age of participants was 66.5 (SD 10.1) years. Intervention and control groups did not differ significantly in 6-month change in maximal treadmill walking distance (average (SE) 24.5 (19.6) meters versus 39.2 (19.6) meters; p = 0.60). Among secondary outcomes, for the intervention and control groups, respectively, average walking speed scores increased by 5.7 (2.2) units and decreased by 1.9 (2.8) units (p = 0.03); the mental health quality of life subscale score increased by 3.2 (1.5) and decreased by 2.4 (1.5) units (p = 0.01). CONCLUSIONS A home-based walking intervention did not improve walking distance but did improve walking speed and quality of life in people with diabetes and PAD. Clinicians should consider recommending home-based walking therapy for such patients.
Copyright American Diabetes Association. Reprinted with permission from The American Diabetes Association.

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