{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:57:55Z","timestamp":1777593475190,"version":"3.51.4"},"reference-count":41,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:00:00Z","timestamp":1666310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National, Health and Medical Research Council, Queensland Government, Medical Research Futures Fund, Heart Foundation and Townsville Hospital and Health services"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Background: This study aimed to investigate whether home exercise programs informed by wearable activity monitors improved walking ability of patients with peripheral artery disease (PAD). Methods: A systematic literature search was performed to identify randomised controlled trials (RCT) testing home exercise that were or were not informed by wearable activity monitors. The primary outcome was the change in walking distance measured by a six-minute walking test or treadmill test over the course of the trial. Network meta-analysis (NMA) was performed using the gemtc R statistical package. The risk of bias was assessed using Cochrane tool for assessing risk of bias in RCTs (RoB 2.0). Results: A total of 14 RCTs involving 1544 participants were included. Nine trials used wearable activity monitors to inform the home exercise program tested, while five trials did not use wearable activity monitors to inform the home exercise program tested. Overall quality assessment showed 12 trials to be at low risk of bias and two trials at high risk of bias. Home exercise programs informed by wearable activity monitors significantly improved walking distance compared to non-exercise controls (Mean difference, MD: 32.8 m [95% credible interval, CrI: 6.1, 71.0]) but not compared to home exercise programs not informed by wearable activity monitors (MD: 4.7 m [95% CrI: \u221238.5, 55.4]). Conclusions: Home exercise informed by wearable activity monitors improve walking ability of patients with PAD. It is, however, unclear if activity monitoring informed exercise programs are more effective than exercise programs not using activity monitors.<\/jats:p>","DOI":"10.3390\/s22208070","type":"journal-article","created":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T10:09:23Z","timestamp":1666606163000},"page":"8070","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Network Meta-Analysis of Trials Testing If Home Exercise Programs Informed by Wearables Measuring Activity Improve Peripheral Artery Disease Related Walking Impairment"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0322-6147","authenticated-orcid":false,"given":"Shivshankar","family":"Thanigaimani","sequence":"first","affiliation":[{"name":"The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia"},{"name":"The Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4371-8752","authenticated-orcid":false,"given":"Harry","family":"Jin","sequence":"additional","affiliation":[{"name":"The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia"},{"name":"The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, QLD 4814, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3152-7564","authenticated-orcid":false,"given":"Munasinghe Tharindu","family":"Silva","sequence":"additional","affiliation":[{"name":"The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia"},{"name":"The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, QLD 4814, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5779-8848","authenticated-orcid":false,"given":"Jonathan","family":"Golledge","sequence":"additional","affiliation":[{"name":"The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia"},{"name":"The Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia"},{"name":"The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, QLD 4814, Australia"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1038\/s41569-021-00663-9","article-title":"Update on the pathophysiology and medical treatment of peripheral artery disease","volume":"19","author":"Golledge","year":"2022","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e019672","DOI":"10.1161\/JAHA.120.019672","article-title":"Network Meta-Analysis Comparing the Outcomes of Treatments for Intermittent Claudication Tested in Randomized Controlled Trials","volume":"10","author":"Thanigaimani","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"809","DOI":"10.5551\/jat.53660","article-title":"Asia-Pacific Consensus Statement on the Management of Peripheral Artery Disease: A Report from the Asian Pacific Society of Atherosclerosis and Vascular Disease Asia-Pacific Peripheral Artery Disease Consensus Statement Project Committee","volume":"27","author":"Abola","year":"2020","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1001\/jama.2021.2536","article-title":"Effect of Low-Intensity vs High-Intensity Home-Based Walking Exercise on Walk Distance in Patients With Peripheral Artery Disease: The LITE Randomized Clinical Trial","volume":"325","author":"McDermott","year":"2021","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/HCR.0000000000000046","article-title":"Illness beliefs and walking behavior after revascularization for intermittent claudication: A qualitative study","volume":"34","author":"Cunningham","year":"2014","journal-title":"J. Cardiopulm. Rehabil. Prev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.avsg.2016.02.009","article-title":"A Systematic Review of the Uptake and Adherence Rates to Supervised Exercise Programs in Patients with Intermittent Claudication","volume":"34","author":"Harwood","year":"2016","journal-title":"Ann. Vasc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1002\/bjs.11101","article-title":"Meta-analysis of clinical trials examining the benefit of structured home exercise in patients with peripheral artery disease","volume":"106","author":"Golledge","year":"2019","journal-title":"Br. J. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e11819","DOI":"10.2196\/11819","article-title":"Consumer-Based Wearable Activity Trackers Increase Physical Activity Participation: Systematic Review and Meta-Analysis","volume":"7","author":"Brickwood","year":"2019","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e192","DOI":"10.2196\/jmir.3469","article-title":"Behavior change techniques implemented in electronic lifestyle activity monitors: A systematic content analysis","volume":"16","author":"Lyons","year":"2014","journal-title":"J. Med. Internet. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1177\/0733464815624151","article-title":"Older Adults\u2019 Acceptance of Activity Trackers","volume":"36","author":"Preusse","year":"2017","journal-title":"J. Appl. Gerontol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.amepre.2015.01.020","article-title":"Randomized Trial of a Fitbit-Based Physical Activity Intervention for Women","volume":"49","author":"Marcus","year":"2015","journal-title":"Am. J. Prev. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e64","DOI":"10.2196\/mhealth.7179","article-title":"Assessing the Impact of a Novel Smartphone Application Compared With Standard Follow-Up on Mobility of Patients With Knee Osteoarthritis Following Treatment With Hylan G-F 20: A Randomized Controlled Trial","volume":"5","author":"Skrepnik","year":"2017","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e001107","DOI":"10.1161\/JAHA.114.001107","article-title":"Step-monitored home exercise improves ambulation, vascular function, and inflammation in symptomatic patients with peripheral artery disease: A randomized controlled trial","volume":"3","author":"Gardner","year":"2014","journal-title":"J. Am. Heart Assoc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1001\/jama.2013.7231","article-title":"Home-based walking exercise intervention in peripheral artery disease: A randomized clinical trial","volume":"310","author":"McDermott","year":"2013","journal-title":"JAMA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1001\/jama.2018.3275","article-title":"Effect of a Home-Based Exercise Intervention of Wearable Technology and Telephone Coaching on Walking Performance in Peripheral Artery Disease: The HONOR Randomized Clinical Trial","volume":"319","author":"McDermott","year":"2018","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1177\/1358863X15577857","article-title":"The development and pilot randomised controlled trial of a group education programme for promoting walking in people with intermittent claudication","volume":"20","author":"Tew","year":"2015","journal-title":"Vasc. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1177\/1358863X18762599","article-title":"Minimal clinically important differences in treadmill, 6-minute walk, and patient-based outcomes following supervised and home-based exercise in peripheral artery disease","volume":"23","author":"Gardner","year":"2018","journal-title":"Vasc. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e000711","DOI":"10.1161\/JAHA.113.000711","article-title":"Home-based walking exercise in peripheral artery disease: 12-month follow-up of the GOALS randomized trial","volume":"3","author":"McDermott","year":"2014","journal-title":"J. Am. Heart Assoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_20","unstructured":"Higgins, J.P.T., and Sally, G. (2011). Cochrane Handbook for SystematicReviews of Interventions, The Cochrane Collaboration."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1136\/bmj.331.7521.903","article-title":"Standard deviations and standard errors","volume":"331","author":"Altman","year":"2005","journal-title":"BMJ"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Higgins, J.P., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2019). Cochrane Handbook for Systematic Reviews of Interventions, John Wiley & Sons.","DOI":"10.1002\/9781119536604"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"25","DOI":"10.18637\/jss.v080.i05","article-title":"Performing Arm-Based Network Meta-Analysis in R with the pcnetmeta Package","volume":"80","author":"Lin","year":"2017","journal-title":"J. Stat. Softw."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1002\/sim.3767","article-title":"Checking consistency in mixed treatment comparison meta-analysis","volume":"29","author":"Dias","year":"2010","journal-title":"Stat. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jclinepi.2010.03.016","article-title":"Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis: An overview and tutorial","volume":"64","author":"Salanti","year":"2011","journal-title":"J. Clin. Epidemiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1001\/jama.2022.3391","article-title":"Effect of a Home-Based, Walking Exercise Behavior Change Intervention vs Usual Care on Walking in Adults With Peripheral Artery Disease: The MOSAIC Randomized Clinical Trial","volume":"327","author":"Bearne","year":"2022","journal-title":"JAMA"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2174","DOI":"10.2337\/dc10-2399","article-title":"Effects of a home-based walking intervention on mobility and quality of life in people with diabetes and peripheral arterial disease: A randomized controlled trial","volume":"34","author":"Collins","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.amjcard.2018.05.018","article-title":"Effects of a 12-Week mHealth Program on FunctionalCapacity and Physical Activity in Patients With PeripheralArtery Disease","volume":"122","author":"Duscha","year":"2018","journal-title":"Am. J. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1161\/CIRCULATIONAHA.110.963066","article-title":"Efficacy of quantified home-based exercise and supervised exercise in patients with intermittent claudication: A randomized controlled trial","volume":"123","author":"Gardner","year":"2011","journal-title":"Circulation"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1016\/S0140-6736(66)92191-X","article-title":"Effect of Daily Muscular Exercise in Patients with Intermittent Claudication","volume":"288","author":"Larsen","year":"1966","journal-title":"Lancet"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e187959","DOI":"10.1001\/jamanetworkopen.2018.7959","article-title":"Efficacy of Community-Based Exercise Therapy among African American Patients With Peripheral Artery Disease: A Randomized Clinical Trial","volume":"2","author":"Collins","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1177\/1099800419884642","article-title":"Low-Intensity Exercise Training Increases Heart Rate Variability in Patients With Peripheral Artery Disease","volume":"22","author":"Brenner","year":"2020","journal-title":"Biol. Res. Nurs."},{"key":"ref_34","first-page":"471","article-title":"The impact of short term supervised and home-based walking programmes on heart rate variability in patients with peripheral arterial disease","volume":"6","author":"Sandercock","year":"2007","journal-title":"J. Sports Sci. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.jvs.2020.03.052","article-title":"Meaningful change in 6-minute walk in people with peripheral artery disease","volume":"73","author":"McDermott","year":"2021","journal-title":"J. Vasc. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s40520-018-0960-7","article-title":"Self-monitoring to increase physical activity in patients with cardiovascular disease: A systematic review and meta-analysis","volume":"31","author":"Kanejima","year":"2019","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1896","DOI":"10.1016\/j.apmr.2012.06.015","article-title":"Determination of the effectiveness of accelerometer use in the promotion of physical activity in cardiac patients: A randomized controlled trial","volume":"93","author":"Izawa","year":"2012","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/S2213-8587(16)30284-4","article-title":"Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): A randomised controlled trial","volume":"4","author":"Finkelstein","year":"2016","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e001233","DOI":"10.1161\/JAHA.114.001233","article-title":"Cost-effectiveness of supervised exercise, stenting, and optimal medical care for claudication: Results from the Claudication: Exercise Versus Endoluminal Revascularization (CLEVER) trial","volume":"3","author":"Reynolds","year":"2014","journal-title":"J. Am. Heart Assoc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.ejvs.2020.11.044","article-title":"Wearable Activity Monitors in Home Based Exercise Therapy for Patients with Intermittent Claudication: A Systematic Review","volume":"61","author":"Chan","year":"2021","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1109\/MCE.2016.2614524","article-title":"Are smartphones ubiquitous? An in-depth survey of smartphone adoption by seniors","volume":"6","author":"Berenguer","year":"2016","journal-title":"IEEE Consum. Electron. Mag."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/20\/8070\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:59:06Z","timestamp":1760144346000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/20\/8070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,21]]},"references-count":41,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["s22208070"],"URL":"https:\/\/doi.org\/10.3390\/s22208070","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,21]]}}}