LAUSR

BACKGROUND Patients with peripheral artery disease and associated intermittent claudication can experience significant short-term (for instance, day-to-day) variations in their walking ability. This variability is often viewed as a complication in establishing reliable baseline walking performance levels for individual patients in multi-patient supervised walking programs. METHODS In contrast, the present five-month-long quantified community walking program deliberately focuses on the variability referred to above, searching for its causes. I designed this program to have its training regimen evolve based upon short-term correlations of my daily activities with intermittent claudication. In each walking session in my community, I measured the maximum amount of time I could walk before being stopped by intolerable calf pain and then immediately following that, the amount of time required to recover from that pain, repeating this cycle as many times as I could. I also kept track of the total distance that I covered and the time required for the entire walking session. Entering this data in a spreadsheet when I returned home, I determined the average (AWT) of all the maximum walking times in the session as one measure of my walking ability on a given day. I also used this data to determine my own unique measure of walking performance (WP) that reflected the factors related to walking ability that were most important to me. I then searched for correlations of AWT and WP with my daily activities, using this information to improve my training regimen and walking ability as the program progressed. RESULTS Identifying such correlations during the first half of this five-month long individualized study of my own case, led to a dramatic improvement in my walking performance within one month of introducing regular use of a stationary recumbent bike between walks coupled with walking more than 10 hours after eating. My average maximum walking time increased 3900% from 2.6 (1.2 [standard error of mean]) min to 104 (1) min with no need to rest at all in 6.6 (0.3) km covered at an average speed of 3.8 (0.1) km/hr. CONCLUSIONS This research indicates that there can be significant motivational and performance benefits to bringing patients' own perspectives more fully into the design and execution of individualized, quantified community walking programs.