Stages of health behavior change and factors associated with physical activity in patients with intermittent claudication

Abstract

OBJECTIVE: To analyze, in people with intermittent claudication, the frequency of individuals who are in each of stages of health behavior change to practice physical activity, and analyze the association of these stages with the walking capacity. METHODS: We recruited 150 patients with intermittent claudication treated at a tertiary center, being included those >30-year-old-individuals and who had ankle-arm index <0.90. We obtained socio-demographic information, presence of comorbidities and cardiovascular risk factors and stages of health behavior change to practice physical activity through a questionnaire, they being pre-contemplation, contemplation, preparation, action and maintenance. Moreover, the walking capacity was measured in a treadmill test (Gardner protocol). RESULTS: Most individuals were in the maintenance stage (42.7%), however, when the stages of health behavior change were categorized into active (action and maintenance) and inactive (pre-contemplation, contemplation and preparation),51.3% of the individuals were classified as inactive behavior. There was no association between stages of health behavior change, sociodemographic factors and cardiovascular risk factors. However, patients with intermittent claudication who had lower total walking distance were three times more likely to have inactive behavior. CONCLUSION: Most patients with intermittent claudication showed an inactive behavior and, in this population, lower walking capacity was associated with this behavior.

Association Between Mental Health Burden, Clinical Presentation, and Outcomes in Individuals With Symptomatic Peripheral Artery Disease: A Scientific Statement From the American Heart Association

“…27 For much of the self-management and health behaviors that individuals are encouraged to take up per the PAD guidelines, 41 including smoking cessation, engaging in exercise and walking regimens, and making overall lifestyle changes, there are important factors to understand about behavioral change in humans. There is substantial evidence that readiness to make health behavior changes, the stages of readiness, 42 and the level of selfefficacy 7,27,[43][44][45][46][47][48][49] are predictors of success and the ability for individuals to make meaningful health behavior changes as they relate to managing their PAD, which have been described by models such as the Leventhal et al 50,51 Common Sense Model of Self-Regulation and the Prochaska et al 52 Transtheoretical Model or Stages of Change model.…”

“…Specifically, improving a person's self-efficacy and using motivational interviewing approaches have been successful in increasing physical activity in individuals with PAD. 44,45,47,48 In addition, a brief psychological intervention to modify illness and walking beliefs has resulted in increased daily walking levels in those presenting with intermittent claudication symptoms and cognitive behavioral intervention-based protocols. 46,91 Improving health literacy and psychoeducation also plays an important role, and vascular specialists, health psychologists, psychiatrists, and behavioral health clinicians need to convey how mental health affects vascular health.…”

“…Specifically, improving a person’s self-efficacy and using motivational interviewing approaches have been successful in increasing physical activity in individuals with PAD. 44,45,47,48 In addition, a brief psychological intervention to modify illness and walking beliefs has resulted in increased daily walking levels in those presenting with intermittent claudication symptoms and cognitive behavioral intervention–based protocols. 46,91…”

Clinical Predictors of Ventilatory Threshold Achievement in Patients with Claudication

“…Intermittent claudication, which is the most prevalent symptom of PAD (29), leads to walking impairment reducing physical activity levels (30) and, consequently, worsening the physical fitness in these patients (28). …”

Comparação entre os métodos subjetivo e objetivo para avaliação da capacidade funcional durante tratamento clínico em pacientes com claudicação intermitente

“…The presence of IC symptoms results in reduced physical activities ( 6 ) , thus interfering in functional capacity ( 7 ) , health and quality of life ( 8 ) , and ultimately death due to cardiovascular disease ( 9 , 10 ) . On the other hand, with the purpose of promoting benefits to these patients, physical exercise, associated with drug treatment, is the initial medical treatment recommended for them, considering their significant results in improving functional capacity ( 11 ) , quality of life ( 12 ) and associated comorbidities ( 13 , 14 ) , with surgical ( 15 ) or endovascular ( 16 ) treatment being performed only when clinical treatment does not work effectively.…”