Don’t stop walking: an in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic.

Abstract Aims: We studied the outcomes of peripheral artery disease (PAD) patients enrolled in a structured in-home walking program before the lockdown due to the SARS-CoV-2 epidemic emergency, to determine whether this intervention ensured the maintenance of mobility in the case of strict movement restrictions.Methods: We considered 83 patients (age 72±11, males n=65) enrolled in a rehabilitation program based on two daily 8-minute sessions of slow intermittent in-home walking at a prescribed cadence with circa-monthly hospital visits. During the lockdown period, the program was updated by phone. The 6-minute (6MWD) and pain-free walking distance (PFWD) were measured pre- and postlockdown. Body weight (BW), blood pressure (BP), and the ankle-brachial index (ABI) were also determined.Results: Sixty-six patients were measured 117±23 days after their previous visit. A safe, pain-free execution the prescribed sessions, with a median distance covered of 74 km, was reported. Overall, the 6MWD was stable, while PFWD improved (p<0.001). Decreased BW with stable BP and ABI values were also recorded. When considering the outcome values according to the time of enrollment before the lockdown, new-entry subjects (≤3 months; n=35) obtained significant improvements, while those previously enrolled (>3 months; n= 31) were stable.Conclusion: In PAD patients, a structured exercise program easily performed in a home corridor and guided with phone assistance was adhered to by patients and showed effectiveness in maintaining mobility and risk factor control during the COVID-19 pandemic. Safe structured exercise may involve frail subjects regardless of walking ability, type of home and external conditions.