Smartphone app helps improve physical function in peripheral artery disease

TrackPAD, a mobile phone health app designed specifically for patients with peripheral artery disease (PAD), leads to better exercise outcomes, improving their 6-minute walking distance (6MWD) and disease-related quality of life (QoL), according to a recent study.

“The TrackPAD app seems feasible and suitable for the target group of patients with PAD in terms of supervised exercise therapy (SET) performance. Participants substantially valued the experience of using an app in the management of their care,” the researchers said.

“Still, a further adaption of the visual presentation and the gestural concept that follows a patient-centred approach is needed,” they added.

The present randomized controlled pilot trial enrolled 39 symptomatic PAD patients: 20 received standard care alone while 19 were additionally given the TrackPAD app, a mobile-health intervention that allows them to self-track their physical activity. All participants were asked to continue following their SET according to standard guidelines.

Outcomes included the 6-minute walk test, ankle-brachial index (ABI) measurements, and self-reported physical activity and PAD-QoL. Patients were followed up after 3 months.

Twenty patients showed improvements in their 6MWD, 90 percent (n=18) of whom belonged to the TrackPAD arm. The remaining patient in the intervention arm saw no notable change in distance walked. On the other hand, all 18 participants in the control arm showed decreased distance. [JMIR Mhealth Uhealth 2021;9;e24214]

Analysis per arm confirmed that the TrackPAD group covered a longer distance over 3 months (change, 83.0±72.2 m) while the control group saw significant deterioration (change, –38.8±53.7 m; p<0.001).

TrackPAD, as compared with standard care alone, likewise led to significant improvements in disease-related QoL, particularly in terms of symptom perception, limitations in physical functioning, fear and uncertainty, and positive adaptation. No between-group difference was reported for the 3-month change in self-reported physical activity.

In terms of user feedback, participants rated the app’s functionality, aesthetics, and informational content as either positive or extremely positive. However, pictograms or photos in the app presented areas for improvement, as most users described them as “largely unclear.”

Moreover, TrackPAD improved participants’ attitudes and knowledge regarding SET, as well as their motivation to perform these exercises.

All but three participants said that they would recommend the app to other patients with existing PAD.

Designed for PAD patients, TrackPAD allows users to determine a weekly SET goal and suggested weekly changes to these goals based on their previous completion rates. The app also asks for disease-specific feedback after each SET session, allowing patients to rate their leg pain, breathing, and overall exhaustion. Other features include a personal achievement tracker, a leaderboard, and calendar of upcoming events.

“Using the smartphone–based tool TrackPAD, we found a significant increase in the mean 6MWD at follow-up, indicating a prognostically relevant change in walking ability in patients with moderate PAD,” the researchers said.

“The influence of mobile interventions on long-term prognosis must be evaluated in the future,” they added.