Late effects of a brief psychological intervention in patients with intermittent claudication in a randomized clinical trial. Issue 6 (6th March 2013)

• Record Type: Journal Article
• Authors: Cunningham, M. A.; Swanson, V.; Holdsworth, R. J.; O'Carroll, R. E.
• Is Part Of: British journal of surgery. Volume 100:Issue 6(2013:Jun.)
• Page Start: 756
• Page End: 760
• Publication Date: 2013-03-06
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs.9100
• Languages: English
• ISSNs: 0007-1323

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjs9100-sec-0001" sec-type="section"> <title>Background</title> <p>The authors previously reported the early results of a trial of a brief psychological intervention to increase physical activity in patients with intermittent claudication. After 4 months, participants in the intervention group walked a mean of 1576 more steps per day than control group participants. The present study followed the original participants to determine whether this behaviour change was maintained over 2 years.</p> </sec> <sec id="bjs9100-sec-0002" sec-type="section"> <title>Methods</title> <p>This was a randomized single‐centre parallel‐group trial. Fifty‐eight patients newly diagnosed with intermittent claudication were assigned randomly to one of two groups. The control group (30 patients) received usual care: lifestyle advice and consultation with a vascular surgeon to agree a treatment plan. The treatment group (28) received usual care plus a brief psychological intervention designed to modify illness and walking beliefs, and develop a personalized walking action plan. The primary outcome was daily steps measured by pedometer. Secondary outcomes included revascularization rate, quality of life and perceived pain‐free walking distance. Follow‐up was conducted at 1 and 2 years. Between‐group differences were analysed by analysis of co‐variance.</p> </sec> <sec id="bjs9100-sec-0003" sec-type="section"> <title>Results</title> <p>Participants in the brief psychological intervention group walked significantly more than those in the control group. The mean difference at 1 year was 1374 (95 per cent confidence interval 528 to 2220) steps per day and the difference at 2 years was 1630 (495 to 2765) steps per day.</p> </sec> <sec id="bjs9100-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Modifying illness and walking beliefs, and assisting patients to develop a personalized walking action plan led to increases in walking behaviour in patients with claudication that were maintained for 2 years. Registration number: ISRCTN28051878 (http://www.controlled-trials.com).</p> </sec> </abstract>