The Role of Home-Based Exercise in the Management of Peripheral Artery Disease

Supervised-exercise therapy (SET) is a cornerstone intervention for management of peripheral artery disease (PAD) and is associated with improvement in ambulatory functional status. Despite strong evidence supporting the benefits of SET, accessibility and adherence remains a challenge, underling its full clinical potential. Home-based exercise therapy (HBET) has emerged as more accessible alternative to SET. This paper reviews the benefits of exercise in PAD, explores the role of home-based exercise therapy in the management of PAD, and describes the essential components of HBET in contemporary clinical practice. HBET programs have demonstrated similar improvements in ambulatory function, including walking distance and pain-free walking distance, as established SET regimens. Recent clinical trials and meta-analysis have established HBET as a reasonable alternative to SET, as reflected in the latest multi-societal clinical guidelines. Functional and quality of life improvements with HBET parallel those with SET and outperform routine exercise education. Successful HBET should include both monitoring and behavioral intervention components to improve adherence and long-term symptomatic improvements. Providers should tailor HBET to the individual patient’s needs and limitations. Ongoing research aims to understand the optimal platform to deliver HBET programs to a wide range of patients with symptomatic PAD.