Monitored exercise program can save life, limb

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This is the time of year when everyone takes a hard look in the mirror (or at the scale) and promises, “I’m going to begin exercising.”

One of the easiest ways to begin is simply by putting one foot in front of the other. Research has shown that the benefits of walking or engaging in other moderate physical activity for 30 minutes a day are numerous.

Simply putting on your walking shoes and keeping a brisk pace around your neighborhood, the local school track or even the shopping mall can help reduce your risk of coronary heart disease; improve your blood pressure, blood sugar levels and blood lipid profile; lower your risk of obesity, breast and colon cancer; and even help your mental well being.
However, if you’re one of the 8 million Americans suffering from Peripheral Arterial Disease, walking might be nearly impossible. PAD is a circulatory problem in which narrowed arteries reduce blood flow to the limbs.

PAD can cause debilitating pain, which leads sufferers to remain sedentary and feeds into a cycle of vascular and heart disease. In addition to poor quality of life, PAD may lead to loss of limb and even loss of life because of the increased risk of heart attack and stroke.

Studies show that about 20% of patients with PAD and leg pain when walking may die from a heart attack or stroke within five years of diagnosis.

That is why Hoag Hospital offers a comprehensive approach to treatment of patients with PAD that combines medical therapy and surgical interventions with a scientifically proven, clinically tested, first-line therapy: a supervised walking program.

The PAD Supervised Walking Exercise Program might sound odd at first blush. Why would walking require supervision? Supervised exercise is not like going to the gym. Monitored by a trained registered nurse and an exercise physiologist, patients going through the county’s only PAD Supervised Walking Exercise Program undergo medical assessments during each of their one-hour visits three days per week. Their progress is meticulously monitored over six months.

In several clinical trials, supervised exercise has been shown to decrease pain, improve how far patients can walk and reduce their risk of amputation, heart attack and stroke, which is why it is recommended as a first-line therapy by the American Heart Assn., the Society for Vascular Medicine and the American College of Cardiology.

Since beginning our program in the fall, we have seen this conservative first-line therapy change lives even when patients had been told that because their pain and vascular disease were so advanced, nothing else could be done for them.

In some cases, our patients have been able to double the distances they can walk. In others, they were finally able to return to daily functions that had been too painful or difficult to endure.

Of course, for most people, supervised exercise is not necessary, but exercise is! Five days a week, for 30 minutes a day, try to walk briskly enough that you cannot carry on a conversation. Walk with your spouse or children. Walk with your dog. Or come to Hoag and walk on our treadmill under trained supervision.

Whatever your needs, and whatever your fitness level, my advice remains the same: Walk it off.

Dr. Ehab Mady is the medical director of the Hoag Hospital Vascular Services Program.