Free-living Physical Activity as a Novel Outcome Measure in Patients with Intermittent Claudication

Clarke, Clare; Holdsworth, R. J.; Ryan, Cormac; Granat, Malcolm

doi:10.1016/j.ejvs.2012.11.027

Cited by 28 publications

(29 citation statements)

References 20 publications

(16 reference statements)

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“…The majority of the articles ( n = 21) were cross-sectional studies while those remaining were prospective longitudinal cohort studies ( n = 3). Of the 24 studies, one examined older adults from residential aged care [ 17 ], six focused on older hospital inpatients [ 3 , 18 , 23 , 24 , 25 , 26 ] eight examined community-dwelling older adults [ 8 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ] and nine focused on individuals from outpatient clinics [ 7 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Study sample sizes ranged from 10 to 1324 people.…”

Section: Resultsmentioning

confidence: 99%

“…The activPAL was worn for 24 h per day over seven days in 71% ( n = 17) of the studies [ 7 , 8 , 17 , 26 , 27 , 28 , 29 , 30 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Others reported a wear time of six to seven hours in one day [ 18 ], 24 h per day over one to two [ 23 , 25 ], three, or eight days [ 3 , 24 ] and waking hours over three or five days [ 31 , 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies reported mean or median step count per day [ 7 , 17 , 24 , 26 , 27 , 34 , 35 , 36 , 37 , 39 , 40 , 41 ]. The lowest step count was found in a sample of older adults post-opeeratively following hip fracture with a median of 35.7 (standard deviation [SD] = 35.7) steps per day [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

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Measuring Activity Performance of Older Adults Using the activPAL: A Rapid Review

et al. 2017

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Current measures of physical activity and sedentary behaviors such as questionnaires and functional assessments are insufficient to provide comprehensive data on older adults. In response, the use of activity monitors has increased. The purpose of this review was to summarize and assess the quality of observational literature on activity measuring of older adults using the activPAL activity monitor. Seventeen databases and a bibliography, compiled by the activPAL creators, were searched. Articles were included if they were in English, were peer-reviewed, included people 65 years or older, measured activity using the activPAL and reported at least one of the following outcomes: step count, hours upright, hours sitting/lying, hours stepping, or hours standing. The search revealed 404 titles; after exclusions 24 were included in the final review. Of these studies, one examined older adults from residential aged care, six from hospital in-patient clinics, nine from outpatient clinics and eight examined community-dwellers. Mean age ranged from 66.0 to 84.2 years. Not all studies reported similar outcome variables, preventing data pooling. The review found a lack of high quality articles. There may be limitations to using the activPAL among older adults but further research is required to examine its use in this population.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Measuring Activity Performance of Older Adults Using the activPAL: A Rapid Review

et al. 2017

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“…Data are checked to ensure data has been recorded for the period, and if not, participants are asked to redo the assessment. The activPAL3™ has been reported to be reliable and valid in the assessment of walking, body posture, and sedentary behavior during free-living activity [57, 59, 60] and when used with older adults [61] and patients with IC [62]. …”

Section: Methodsmentioning

confidence: 99%

“…Individuals with PAD have a greater EBCI than age matched controls, which indicates a fragmented stop/start walking pattern [47, 62]. …”

Section: Methodsmentioning

confidence: 99%

Efficacy of brief behavioral counselling by allied health professionals to promote physical activity in people with peripheral arterial disease (BIPP): study protocol for a multi-center randomized controlled trial

et al. 2016

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BackgroundPhysical activity is recommended for people with peripheral arterial disease (PAD), and can improve walking capacity and quality of life; and reduce pain, requirement for surgery and cardiovascular events. This trial will assess the efficacy of a brief behavioral counselling intervention delivered by allied health professionals to improve physical activity in people with PAD.MethodsThis is a multi-center randomised controlled trial in four cities across Australia. Participants (N = 200) will be recruited from specialist vascular clinics, general practitioners and research databases and randomised to either the control or intervention group. Both groups will receive usual medical care, a written PAD management information sheet including advice to walk, and four individualised contacts from a protocol-trained allied health professional over 3 months (weeks 1, 2, 6, 12). The control group will receive four 15-min telephone calls with general discussion about PAD symptoms and health and wellbeing. The intervention group will receive behavioral counselling via two 1-h face-to-face sessions and two 15-min telephone calls. The counselling is based on the 5A framework and will promote interval walking for 3 × 40 min/week. Assessments will be conducted at baseline, and 4, 12 and 24 months by staff blinded to participant allocation. Objectively assessed outcomes include physical activity (primary), sedentary behavior, lower limb body function, walking capacity, cardiorespiratory fitness, event-based claudication index, vascular interventions, clinical events, cardiovascular function, circulating markers, and anthropometric measures. Self-reported outcomes include physical activity and sedentary behavior, walking ability, pain severity, and health-related quality of life. Data will be analysed using an intention-to-treat approach. An economic evaluation will assess whether embedding the intervention into routine care would likely be value for money. A cost-effectiveness analysis will estimate change in cost per change in activity indicators due to the intervention, and a cost-utility analysis will assess change in cost per quality-adjusted life year. A full uncertainty analysis will be undertaken, including a value of information analysis, to evaluate the economic case for further research.DiscussionThis trial will evaluate the efficacy and cost-effectiveness of a brief behavioral counselling intervention for a common cardiovascular disease with significant burden.Trial registrationACTRN 12614000592640 Australian New Zealand Clinical Trials Registry. Registration Date 4 June 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3801-7) contains supplementary material, which is available to authorized users.

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Effect of Brief Counseling by Allied Health Professionals on Step Count of People With Peripheral Artery Disease

et al. 2023

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ImportanceIt is unclear how to effectively promote walking in people with peripheral artery disease (PAD).ObjectiveTo test whether brief counseling delivered by allied health professionals increases step count in participants with PAD.Design, Setting, and ParticipantsIn this randomized clinical trial, participants with symptomatic PAD were recruited from sites in Australia and randomly allocated 1:1 to the counseling intervention or an attention control. Data were collected from January 2015 to July 2021, and data were analyzed from March to November 2022.InterventionsTwo 1-hour face-to-face and two 15-minute telephone counseling sessions designed to increase walking.Main Outcomes and MeasuresThe primary outcome was the between-group difference in change in daily step count estimated by accelerometer recordings over 7 days at baseline and 4 months, using imputation for missing values. Other outcomes at 4, 12, and 24 months included step count, 6-minute walk distance, and disease-specific and generic measures of health-related quality of life. Risk of major adverse limb events was assessed over 24 months.ResultsOf 200 included participants, 144 (72.0%) were male, and the mean (SD) age was 69.2 (9.3) years. The planned sample of 200 participants was allocated to the counseling intervention group (n = 102) or attention control group (n = 98). Overall, 198 (99.0%), 175 (87.5%), 160 (80.0%) and 143 (71.5%) had step count assessed at entry and 4, 12, and 24 months, respectively. There was no significant between-group difference in the primary outcome of change in daily step count over 4 months (mean steps, 415; 95% CI, −62 to 893; P = .07). Participants in the counseling group had significantly greater improvement in the secondary outcome of disease-specific Intermittent Claudication Questionnaire score at 4 months (3.2 points; 95% CI, 0.1-6.4; P = .04) and 12 months (4.3 points; 95% CI, 0.5-8.1; P = .03) but not at 24 months (1.2 points; 95% CI, −3.1 to 5.6; P = .57). Findings were similar for mean PAD Quality of Life Questionnaire component assessing symptoms and limitations in physical functioning (4 months: 1.5 points; 95% CI, 0.3-2.8; P = .02; 12 months: 1.8 points; 95% CI, 0.3-3.3; P = .02; 24 months: 1.3 points; 95% CI. −0.5 to 3.1; P = .16). There was no significant effect of the intervention on change in mean 6-minute walking distance (4 months: 9.3 m; 95% CI, −3.7 to 22.3; P = .16; 12 months: 13.8 m; 95% CI, −4.2 to 31.7; P = .13; 24 months: 1.2 m; 95% CI, −20.0 to 22.5; P = .91). The counseling intervention did not affect the rate of major adverse limb events over 24 months (12 [6.0%] in the intervention group vs 11 [5.5%] in the control group; P &gt; .99).Conclusions and RelevanceThis randomized clinical trial found no significant effect of brief counseling on step count in people with PAD. Alternate interventions are needed to enable walking.Trial RegistrationAustralian New Zealand Clinical Trials Registry Identifier: ACTRN12614000592640

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Free-living Physical Activity as a Novel Outcome Measure in Patients with Intermittent Claudication

Abstract: The classic fragmented stop/start walking pattern universally described by individuals with IC can be quantified using the EBCI. This method of measurement potentially provides a novel method of assessing the effectiveness of clinical interventions for this patient group.

Cited by 28 publications

References 20 publications

Measuring Activity Performance of Older Adults Using the activPAL: A Rapid Review

Measuring Activity Performance of Older Adults Using the activPAL: A Rapid Review

Efficacy of brief behavioral counselling by allied health professionals to promote physical activity in people with peripheral arterial disease (BIPP): study protocol for a multi-center randomized controlled trial

Effect of Brief Counseling by Allied Health Professionals on Step Count of People With Peripheral Artery Disease

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