This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Late effects of a brief psychological intervention in patients with intermittent claudication in a randomized clinical trial. BJS 2013; 100: 756-760.
Published: 6th March 2013
Authors: M. A. Cunningham, V. Swanson, R. J. Holdsworth, R. E. O'Carroll
Background
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.
Method
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.
Results
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.
Conclusion
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:
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