Volume 29, Issue 159, May 2025

Walking as Therapy - The Role of Walking Training in the Management of Peripheral Arterial Disease

Adam Woźniak^1♦, Katarzyna Żyro², Wiktor Żyro¹, Karolina Woźniak¹, Michał Stasiak³, Franciszek Glapiński³

¹St. Anne's Trauma Surgery Hospital, Barska Str. 16/20, 02-315 Warsaw, Poland
²Independent Public Health Care Facilities in Pruszków, al. Armii Krajowej 2/4, 05-800 Pruszków, Poland
³Central Clinical Hospital, 1a Banacha Str. 02-097 Warsaw, Poland

^♦Corresponding author
Adam Woźniak, St. Anne's Trauma Surgery Hospital, Barska Str. 16/20, 02-315 Warsaw, Poland

ABSTRACT

Peripheral artery disease (PAD) is a common condition that limits walking and reduces quality of life. Walking training is now recognized as a key part of treatment. This review summarizes recent studies on walking-based exercise in PAD. We researched PubMed for studies published between January 2019 and March 2025. Only randomized trials, meta-analyses, and systematic reviews were included. The primary outcomes were walking distance and exercise tolerance. Moderate-intensity walking improved both pain-free and maximal walking distances better than vigorous exercise. Walking after stenting helped reduce the risk of in-stent restenosis. Mobile health tools supported home-based programs and improved walking ability. Some programs also increased adherence. Effects on quality of life were mixed. Supervised exercise therapy (SET) was as effective as revascularization in improving function while being more cost-effective. Home programs with monitoring worked nearly as well as SET. Blood flow restriction training and arm ergometry helped patients who could not tolerate walking. Short and frequent exercise programs were well tolerated and effective, with satisfying results. SET was found to improve cardiovascular responses and reduce symptoms of anxiety and depression. Walking training is safe and flexible. It should be adapted to patient needs. Future work should focus on adherence and personalizing treatment.

Keywords: Peripheral artery disease, intermittent claudication, walking training, exercise therapy

Medical Science, 2025, 29, e68ms3567

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DOI: https://doi.org/10.54905/disssi.v29i158.e68ms3567

Published: 18 May 2025