Late effects of a brief psychological intervention in patients with intermittent claudication in a randomized clinical trial

Cunningham, M.A., Swanson, V., Holdsworth, R.J., and O'Carroll, R.E. (2013) Late effects of a brief psychological intervention in patients with intermittent claudication in a randomized clinical trial. British Journal of Surgery, 100 (6). pp. 756-760.

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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.

Methods: 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: ISRCTN28051878 (

Item ID: 32240
Item Type: Article (Research - C1)
ISSN: 1365-2168
Additional Information:

Presented to the Annual General Meeting of the Vascular Society of Great Britain and Ireland, Edinburgh, UK, November 2011, the Seventh Annual Scientific Meeting of the UK Society for Behavioural Medicine, Stirling, UK, December 2011, and the Tenth Annual Scientific Conference of the Australasian Society for Behavioural Health and Medicine, Newcastle, New South Wales, Australia, February 2013.

Funders: Chief Scientist Office Scotland
Date Deposited: 14 Apr 2014 23:21
FoR Codes: 17 PSYCHOLOGY AND COGNITIVE SCIENCES > 1701 Psychology > 170106 Health, Clinical and Counselling Psychology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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