Innovative project creates mobile application to prevent and treat Peripheral Arterial Disease
13th May 2021
The WalkingPAD project aims to study and develop an outpatient exercise programme, focusing on the education and co-responsibility of patients with Peripheral Arterial Disease (PAD). The new WalkingPAD technology, accessible through a mobile application, and complemented with a web platform, integrates mobile technologies and geolocation systems, enabling the creation and monitoring of an individualised exercise plan for each patient, similar to hospital rehabilitation programmes.
In this sense, the project promotes the performance of personalised medicine within the community, by educating and motivating patients, through remote supervision; this solution is particularly interesting, since the patients can use it in their family environment. The project aims to increase patients' willingness to exercise, the average distance covered without pain (caused by muscle ischemia), and the overall physical and psychological well-being.
This new therapeutic strategy, covering 120 patients at Porto University Hospital Centre (CHUP), shows significant potential for replicability, implementation and applicability in all patients with cardiovascular diseases, in addition to peripheral arterial disease. Thanks to WalkingPAD, physical exercise is prescribed as a key tool, in terms of not only intervention, but also considering the prevention of physical and/or mental illnesses.
WalkingPAD is being developed by the Angiology and Vascular Surgery (Porto University Hospital Centre), in partnership with the Institute for Systems and Computer Engineering, Technology and Science (INESC TEC) and the Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), of the University of Trás-os-Montes and Alto Douro (UTAD). The project is funded by the Foundation for Science and Technology (FCT), and co-financed by Norte2020.
Ivone Silva, Vascular Surgeon at CHUP, associate professor at the Institute of Biomedical Sciences Abel Salazar (ICBAS), researcher at the Unit for Multidisciplinary Research in Biomedicine (UMIB), also part of ICBAS, and head researcher responsible for the implementation of the new technology in CHUP patients, mentioned that "it is necessary to focus on preventing the progression of peripheral arterial disease, by investing in rehabilitation programmes. The main advantage of WalkingPAD over other programmes is its participatory nature and appealing exercises, since patients can perform them in family environment. They are highly personalised, effective, inexpensive and without significant risks, superior to those performed in hospitals.
Susana Pedras, clinical and health psychologist, with a PhD in Applied Psychology, researcher at FCT, and project manager, is responsible for the motivational intervention towards behavioural changes – namely increasing the patients’ willingness to perform prescribed exercise routines. "These patients are, in general, inactive people who avoid any type of physical activity, because they feel a lot a pain". The goal of psychological intervention is developing motivation mechanisms that are more autonomous, by promoting and improving psychological nutrients - the basic psychological needs of any human being -, like the need to feel fit and independent, as well as the need for a social relationship/bond. “We do not focus exclusively on helping the patients adopt new behaviours, but rather preserving said behaviours over time”.
Hugo Paredes (INESC TEC), the co-researcher responsible for the project, stated that “WalkingPAD prioritises advanced technologies, namely biometrics, thus enabling advances in terms of precision, cost, user-friendliness/willingness, protection of privacy, diagnosis and treatment, via smart monitoring, and a more comprehensive awareness of health/disease aspects. The use of artificial intelligence algorithms to determine patterns in PAD patients’ gait gives WalkingPAD the ability to recommend breaks, namely when limping pain intensifies, thus avoiding extreme situations”.
Catarina Abrantes, researcher at CIDESD-UTAD pointed out that “the new technologies for capturing and processing continuous data enable personalised monitoring of the walking period in each exercise session, and in each week”.
ON PERIPHERAL ARTERIAL DISEASE
Cardiovascular diseases are considered the leading cause of death worldwide, with the 2013 Global Burden of Disease study estimating that 31.5% of all deaths are a result of said diseases. Moreover, Peripheral Arterial Disease (PAD) of lower limbs is a common cardiovascular disease that affects 27 million people in Europe and the United States.
PAD is characterised by the lack of blood flow to the legs’ arteries, due to atherosclerosis - the main consequence of which is the presence of signs and symptoms associated with the lack of blood. It is estimated that a fifth of people over 60 suffer from this disease. If not treated in a timely manner, it can ultimately lead to amputation of the lower limbs. In addition, this disease is also a potential factor for the increase in cardiovascular events, morbidity and mortality associated with other cardiovascular diseases, like those of cardiac and cerebrovascular diseases.
Intermittent claudication is the most common symptom, and it translates into pain in the legs’ muscles; it is caused by exercise (e.g., walking), and it decreases when patients rest for longer periods. The pain leads to the reduction of walking distances over time, consequently resulting in an inactive lifestyle - thus reducing physical aptitude and increasing long-term cardiovascular risks. Consequently, there is an increasing morbidity, mortality and reduced quality of life.
Despite being a chronic disease, there are effective treatments for PAD, focused on reducing and controlling the limitations caused by the symptoms. These actions involve the control of risk factors and a regular exercise routine (walking), perceived as first-line treatment among these patients. When performed successfully, it could lead reduce the number of patients in need of surgical treatment, the personal, socioeconomic, and hospitalisation costs, and associated morbidity and mortality. It is important to mention that, when left untreated, PAD can increase the risks of lower limb amputation.
For further inquiries:
Eunice Oliveira
Communication Service
INESC TEC
FEUP Campus
Rua Dr Roberto Frias
4200-465 Porto
Portugal
P +351 22 209 4118
M +351 934 224 331
www.inesctec.pt
Porto – May 15, 2020