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

04 Mar 20264 min read0 viewsJournal Feed

GIST

Journal of the American Heart Association, Volume 15, Issue 6 , March 17, 2026. BackgroundIn‐person walking assessments are time consuming, limiting their clinical use.

This study aimed to identify simple questions that best reflected the walking ability of patients with peripheral artery disease.MethodsThis was a post‐hoc analysis of responses for self‐reported mobility and fatigue‐based questions, and walking distance from the BIP (Behavioral Intervention by Allied Health Professionals to Promote Physical Activity) trial. Responses to questions that predicted minimum clinically important differences in walking distance (20 m) were identified using generalized linear models.

Random forest was used to train the identified questions using baseline data, which were tested for their ability to estimate 6‐minute walking distances measured at 4, 12 and 24 months.

Clinical Editorial

Study design and purpose

A post-hoc analysis examined self-reported mobility and fatigue items alongside walking distance data from the BIP trial.
The objective was to identify brief questions that best reflect walking ability in peripheral artery disease and to evaluate their capacity for remote use.

Population and data sources

The analysis included 188 eligible participants from the BIP trial.
Baseline responses to selected questions were paired with objective 6-minute walk distances measured at 4, 12, and 24 months.

Analytical approach and modeling

Generalized linear models identified questions whose responses predicted a minimum clinically important difference in walking distance, defined as 20 meters.
A random forest approach was employed to train the identified questions on baseline data and test their ability to estimate later 6-minute walk distances across follow-up visits.
Longitudinal relationships between responses and walking distance over 24 months were assessed with linear mixed effects models.

Key findings and predictive questions

Three questions showed predictive value across follow-up:
“Does your health now limit you in climbing 1 flight of stairs?”
“Does your health now limit you in walking 100 m?”
“During the past 4 weeks, did you feel worn out?”
All three demonstrated statistically significant associations with changes in walking distance at 4, 12, and 24 months (P < 0.05).

Magnitude of change

Participants who reported “no limitations in walking 100 m” experienced greater improvements in walking distance over time compared with those reporting greater limitations.
The reported mean difference in walking distance for this contrast was 25.1 meters (95% CI 11.1–39.1) when comparing baseline to follow-up across time points (P < 0.001).