What is your research? How did you get into it and why this area?
I am an exercise physiologist and my area of research is peripheral artery disease (PAD). I got into this area because my grandmother had PAD for many years which negatively impacted her overall health and quality of life. I wanted to know what treatment options were available for my grandmother and soon came to realize from reading the available research that exercise training was the best treatment for PAD. Thus my research is looking at how exercise can improve walking ability and health outcomes for patients with PAD. Because I chose this area, I wanted to work with Dr. Judy Regensteiner who is an expert in exercise training for patients with PAD.
Why is this area of research important?
An estimated 8-12 million adults have PAD in the U.S. alone, with worldwide prevalence estimated at 3-10%. PAD leads to premature mortality rates, especially cardiac events, and impacts quality of life for people with PAD. Patients with this disease are typically inactive because many experience severe leg pain when walking, making it difficult to adopt and adhere to walking exercise programs.
Research indicates that supervised exercise programs in hospitals are the gold standard treatment for PAD. However, the current state of the healthcare system limits the exercise treatment options for PAD patients. Insurance reimbursement of exercise training for PAD patients is often not available, thus other options such as home and community-based exercise programs need to be studied to see if they will be as effective as supervised programs for PAD patients. I am working to develop community-based exercise programs that are effective but also convenient for patients’ to complete.
My current project incorporates elements of training, monitoring and coaching (TMC) commonly used in supervised programs. Because supervised programs are effective but not utilized, new exercise training programs that combine the strengths of supervised and community-based programs are needed. The project also includes evaluation of the local walking environment for each PAD patient and seeks to determine how exercise can be performed in the community setting. Barriers to walking in the community may include low quality walking surfaces, poor lighting as well crime and safety concerns. Promoters to exercise in community settings may include walking with friends or family members, dog walking or even ‘cruising’ the neighborhood to get the gossip from neighbors. Thus, identification of the barriers/promoters to walking in the community may provide better access to physical activity that patients’ were previously unaware of. My next project will actively engage the community, which means getting PAD patients involved in the design of the intervention. Research programs that consider patient perspectives in their design rather than programs that are simply conducted in the community may identify additional barriers to walking using knowledge of PAD patients and ultimately improve exercise compliance by tailoring the walking program based on PAD patient preferences.
What are your hopes and dreams for your research?
I would like to see community-based exercise programs implemented on a larger scale so that physician practices use exercise as a primary treatment option for PAD patients. Currently, most home and community exercise recommendations for PAD patients consist of advice given by their physicians to “go home and exercise” – so if my program is successful, then the healthcare provider can give the actual plan, can track it, know what results to look for, and provide structured follow up with feedback from the patient. My other dream is that costs associated with exercise, and particularly community-based programs, will be covered by health insurance. For example, cardiac rehab costs are covered for patients who have had a heart attack, but exercise therapy costs for PAD are not covered. My research seeks to bypass barriers to exercise in the community, which is a pretty bold way to approach an exercise program for PAD patients. My hope is that my program will not only help patients walk better but may also improve quality of life and as well as their risk factors for heart attacks and strokes.
How could we report on your work in a way that could be understood and valued by the general public?
CWHR could help to educate the public about PAD, its causes, consequences, and help deliver the message that the primary treatment for PAD is walking exercise.