Physical Activity and Leg Disorders in Adults in Drug-Treatment

Purpose: We examined how chronic venous disease (CVD), peripheral arterial disease (PAD) and other variables (i.e., health conditions, body mass index, age, years of opioid addiction, site of injection drug use, and motivation for physical activity) affected physical activity in adults in methadone-maintained therapy.

Methodology: The study used a three-drug group, cross-sectional, comparative design with stratification (age, gender, and ethnicity). Participants (N=569) completed physical activity questionnaires and had their legs assessed for CVD and PAD.

Statistics: A 3x2x2x3 multivariate analysis of variance was used to examine relationships among the four physical activity scales and the stratification variables. The relative importance of leg disorders and other predictors of daily physical activity were examined using latent variable regression.

Results: Participants (53% female; 61% African-American; mean age=46 years) had CVD identified in 92.4% and PAD in 18.5%. They walked less than a half mile daily. Participants reported a decrease in walking (58.9%), standing (57.5%), and sports (59.8%) whereas the time spent sitting increased (67.0%) over the past 5 years. Leg injectors had the lowest active living score (p<.05), indicating a decrease in physical activity over the previous 5 years. The more severe the leg disorders or associated risk variables, the fewer physical activities were performed. The set of predictors accounted for 58% of the variance in daily physical activity. The strongest predictor was the motivation for physical activity scale (path=.53).

Conclusions: Persons in drug treatment reported low levels of daily physical activity. Severity of CVD and PAD was negatively associated with physical activity. The strongest predictor of physical activity was motivation. Reasons for low activity need continued exploration. Motivating, individualized, exercise prescriptions that consider leg health will need to be developed.