For a study, researchers sought to compare the impact of a home-based, walking exercise behavior modification intervention administered by physical therapists to conventional treatment in patients with PAD with intermittent claudication. Between January 2018 and March 2020, 190 patients with PAD with intermittent claudication were enrolled in a multicenter randomized clinical study at six hospitals in the United Kingdom; the last follow-up date was September 8, 2020. Participants were randomly assigned to either a walking exercise habit modification intervention administered by physical therapists trained in a motivational approach (n=95) or standard care (n=95). At the 3-month follow-up, the primary outcome was a 6-minute walking distance (minimal clinically important difference, 8-20 m). There were 8 secondary outcomes, three of which were the Walking Estimated Limitation Calculated by History (WELCH) questionnaire (score range, 0 [best performance] to 100), the Brief Illness Perceptions Questionnaire (score range, 0 to 80 [80 indicates negative perception of illness]), and the Theory of Planned Behavior Questionnaire (score range, 3 to 21 [21 indicates the best attitude, subjective norms, perceived behavioral control, or intentions]);
About 148 (78%) of 190 randomized individuals (mean age 68 years, 30% women, 79% White race, mean baseline 6-minute walking distance 361.0 m) completed the 3-month follow-up. The intervention group’s 6-minute walking distance increased from 352.9 m at baseline to 380.6 m at 3 months, whereas the usual care group’s distance increased from 369.8 m to 372.1 m (adjusted mean between-group difference, 16.7 m [95% CI, 4.2 m to 29.2 m]; P =.009). About 5 of the 8 secondary outcomes were non-statistically significant. At 6-month follow-up, baseline WELCH scores in the intervention group increased from 18.0 to 27.8 and in the usual care group increased from 20.7 to 20.7 (adjusted mean between-group difference, 7.4 [95% CI, 2.5 to 12.3]; P =.003), and scores on the Brief Illness Perceptions Questionnaire increased from 45.7 to 38.9 in the intervention group and from 44.0 to 45.8 in the usual care group (adjusted mean between-group difference, −6.6 [95% CI, −9.9 to −3.4]; P<.001), and scores on the attitude component of the Theory of Planned Behavior Questionnaire changed from 14.7 to 15.4 in the intervention group and from 14.6 to 13.9 in the usual care group (adjusted mean between-group difference, 1.4 [95% CI, 0.3 to 2.5]; P = .02). In the intervention group, thirteen significant adverse events occurred, compared to three in the usual care group. All were found to be unconnected to the research or unlikely to be linked.
A home-based, walking exercise behavior modification intervention, compared to standard care, resulted in increased walking distance after 3 months in persons with PAD with intermittent claudication. To assess the long-term viability of the findings, more study was required.
Reference:jamanetwork.com/journals/jama/article-abstract/2790937
