Remote Self-Report Assessment of Walking Impairment in Peripheral Artery Disease.

Three specific self-report questions were predictive of significant differences in 6-minute walking distance at all follow-up time points in PAD patients.

• The three questions identified were: 'Does your health now limit you in climbing 1 flight of stairs?', 'Does your health now limit you in walking 100 m?', and 'During the past 4 weeks, did you feel worn out?'
• All three questions were statistically significant predictors at all follow-up time points (all P<0.05)
• The analysis used generalized linear models to identify questions that predicted minimum clinically important differences in walking distance (20 m)
• Follow-up time points were at 4, 12, and 24 months

Participants who reported no limitations in walking 100 m had significantly greater improvement in walking distance compared to those who reported being limited a lot.

• Mean difference in walking distance was 25.1 m (95% CI, 11.1–39.1; P<0.001)
• This difference was observed between baseline and all follow-up time points
• Analysis was conducted using linear mixed effects models over 24 months
• The comparison was between those reporting 'no limitations in walking 100 m' versus those reporting being 'limited a lot'

A random forest model trained on the identified self-report questions at baseline was able to estimate 6-minute walking distances at 4, 12, and 24 months.

• The random forest model was trained using baseline data from the BIP trial
• The model was tested for its ability to estimate 6-minute walking distances at 4, 12, and 24 months
• 188 eligible participants were included in the analysis
• The study was a post-hoc analysis of the BIP (Behavioral Intervention by Allied Health Professionals to Promote Physical Activity) trial

The study included 188 eligible participants with peripheral artery disease drawn from the BIP trial.

• Data analyzed included self-reported mobility and fatigue-based questions and walking distance
• The BIP trial was a Behavioral Intervention by Allied Health Professionals to Promote Physical Activity trial
• This was a post-hoc analysis of previously collected trial data
• Walking ability was assessed using 6-minute walking distance as the objective outcome measure

In-person walking assessments are time consuming, limiting their clinical use in peripheral artery disease management.

• The study motivation was to identify simple questions that best reflected walking ability of patients with peripheral artery disease
• Remote self-report assessment was proposed as an alternative to in-person walking assessments
• The clinical importance threshold for walking distance was defined as 20 m (minimum clinically important difference)