In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

You must propose high intensity walking exercise to PAD patients!

Read by Marc Ferrini

Main conclusions

Among patients with PAD, low-intensity home-based exercise was significantly less effective than high-intensity home-based exercise and was not significantly different from the non-exercise control for improving six-minute walk distance.

Type of study

Multicenter US study among 305 stage2 PAD (Peripheral Arterial Disease) patients randomised to Low Intensity Walk Exercise (LIWE) (inducing no ischemic leg symptom), High Intensity WE (eliciting moderate to severe leg pain), or non-exercise (control group). Patients of the active groups were asked to walk in an unsupervised setting five times per week for up to 50 minutes per session wearing an accelerometer to document exercise intensity and time. At 12 months, the mean change in six-minute walk distance (primary outcome) was + 34.5m in the HIWE and -6.4m. in the LIWE group (p<0.001), this latter not significantly different from change in the control group (-15.1 m. p=0.44).

Importance for clinical practice

These results do not support the use of low-intensity home-based walking exercise for improving objectively measured walking performance in patients with PAD.


Mary M. McDermott, Bonnie Spring, Lu Tian, Michael H. Croquis et al.

Effect of Low-Intensity vs High-Intensity Home-Based Walking Exercise on walk distance in patients with Peripheral Artery Disease. The LITE Randomized Clinical Trial JAMA. 2021 ;325(13) :1266-1276. doi:10.1001/jama.2021.2536