Exercise Therapy for PAD Using Mobile Health

• Eligible Veteran status
• Clinically stable intermittent claudication (2 months of Rutherford Class II symptoms, no evidence of chronic limb-threatening ischemia)
• Established peripheral artery disease (PAD) diagnosis (abnormal ankle-brachial index or evidence of PAD on prior certified vascular laboratory or radiology imaging)
• Access to safe location to perform walking exercises

Exclusion Criteria:

• Above or below knee amputation

  • critical limb ischemia (rest pain or tissue loss including ulceration or gangrene)
  • inability to walk without a walker
  • wheelchair confinement
  • non-English speaking
  • significant visual impairment that interferes with walking activity
  • hearing impairment that interferes with full study participation
  • unable or unwilling to return to the medical center at the expected visit frequency or unable or unwilling to use the technology required for the intervention
• Individuals whose walking is limited by a condition other than peripheral artery disease (PAD)

• Any active cardiac condition including unstable angina

  • unstable atrial or ventricular arrhythmias
  • high-grade heart block without a pacemaker
  • active myopericarditis
  • recent venous thromboembolism
  • or recent abnormal baseline stress test suggesting ischemia
  • other high-risk findings (e.g., drop of systolic blood > 20 millimetres of mercury (mmHg) with exercise)
• Presence of Class III NYHA heart failure or CCS III angina
• Major surgery including lower extremity revascularization or orthopedic surgery during the preceding three months or anticipated in the next nine months

• Major medical illness including lung disease requiring continuous oxygen (patients wearing nighttime oxygen only may still qualify)

  • neurodegenerative disorders such as Parkinson's Disease that impair walking ability
  • cancer requiring treatment in the past 2 years (with exception for non-melanoma skin cancer or if they received treatment for early-stage cancer with an excellent overall prognosis)
• Heart attack, stroke, or coronary artery bypass surgery in the preceding 3 months

• Mental health illness that may interfere with the ability to consent and/or participate in the study, including mini-mental status examination score \<24

  • dementia
  • active psychiatric disorder such as schizophrenia or bipolar disorder
  • history of suicidal or homicidal ideation in the preceding six months
  • history of suicidal attempts in the preceding 12 months
  • history of active substance use in the preceding six months that would interfere with study participation (as determined by their primary care or mental health provider)
• Subjects endorsing SI or HI may be eligible for continued participation with monitoring if approved by their primary mental health provider
• Currently walking regularly for exercise at a level comparable to the amount of exercise prescribed in the intervention
• Currently enrolled in another clinical trial or structured exercise program (i.e., cardiac rehabilitation)
• Deemed to be poorly suited for the study or the study intervention at the discretion of the principal investigator (PI) or study staff