Motivating Structured Walking Activity in Intermittent Claudication (MOSAIC)

December 10, 2019 updated by: Guy's and St Thomas' NHS Foundation Trust

A Brief Physiotherapist-led Behaviour Change Intervention to Facilitate Walking in Older People With Peripheral Arterial Disease: a Randomised Controlled Trial

Peripheral arterial disease can cause leg pain or discomfort (called intermittent claudication (IC)), which limits the ability to walk and carry out everyday activities. Lifestyle changes, like increasing walking, can lead to improvements, but can be a challenge to begin and then continue. The aim of this study is to investigate if a physiotherapist-led, behaviour change treatment effects walking in people with IC. The treatment is designed to build an understanding of IC and walking exercise and help individuals develop strategies to increase regular walking. The trial will recruit 192 adults (aged 50 years and over) with IC. All participants will visit King's College London or their local hospital to complete two short walking tests and answer questionnaires about their daily activities, beliefs about their symptoms and treatment, quality of life and the costs of having IC.

Participants will then be randomly assigned to receive either the new treatment or continue with their usual NHS care. The new treatment involves two 60-minute face-to-face sessions (at the participant's home or local hospital) and two 20-minute telephone calls with a physiotherapist who will discuss participants' understanding and beliefs about IC, walking and help participants to set goals and plans to increase walking over 12 weeks. Participants will be provided with a step counter (pedometer) and walking record.

After 12 weeks, all participants will attend a second appointment where they will repeat the walking tests and fill out another set of questionnaires. A final set of questionnaires will be completed by all participants after 6 months (by post or electronically). Some participants will be invited to provide feedback on their experience of the treatment and trial by telephone or a face-to-face interview with a researcher.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Anticipated)

192

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

      • London, United Kingdom
        • Recruiting
        • King's College Hospital NHS Foundation Trust
      • London, United Kingdom
        • Recruiting
        • Royal Free London NHS Foundation Trust
      • London, United Kingdom
        • Recruiting
        • Guy's & St Thomas NHS Foundation Trust
      • London, United Kingdom
        • Recruiting
        • Lewisham and Greenwich NHS Trust (GSTT PIC site)
      • London, United Kingdom
        • Recruiting
        • St George's University Hospital NHS Foundation Trust
      • London, United Kingdom
        • Recruiting
        • The Royal London Hospital, Barts Heatth NHS Trust
    • Kent
      • Dartford, Kent, United Kingdom
        • Recruiting
        • Dartford and Gravesham NHS Trust (GSTT PIC site)
      • Maidstone, Kent, United Kingdom
        • Recruiting
        • Maidstone and Tunbridge Wells NHS Trust (GSTT PIC site)
    • Surrey
      • Ashford, Surrey, United Kingdom
        • Recruiting
        • Ashford & St Peter's NHS Foundation Trust

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

50 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • ≥50 years of age;
  • established PAD (Ankle Brachial Pressure Index ≤0.90 and/or radiographic evidence or clinician reported diagnosis) and IC (presence of symptoms reported on the San Diego Claudication Questionnaire)
  • able to participate in MOSAIC
  • able and willing to provide informed consent

Exclusion Criteria:

  • Unstable IC (self-reported change in symptoms during previous 3 months)
  • walking >90 minutes/week (reported on Brief International Physical Activity Questionnaire
  • contraindications to walking exercise (e.g., unstable angina) confirmed by their vascular specialist
  • have completed any prescribed supervised exercise sessions in the previous 6 months or been offered prescribed exercise sessions in the next 6 months.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: MOSAIC Treatment
MOSAIC treatment plus Usual NHS Care. MOSAIC treatment comprises 2 x 60-minute individual face-to-face consultations (weeks 1 & 2) and 2 x 20-minute follow-up telephone calls (weeks 6 & 12) with a trained physiotherapist.
MOSAIC comprises 2 x 60-minute individual face-to-face consultations (weeks 1 & 2) and 2 x 20-minute follow-up telephone calls (weeks 6 & 12) delivered at a convenient time and location of participant's choice (local NHS Trust or participant's home). All sessions are delivered by a trained Band 6/7 physiotherapist. All participants randomized to receive MOSAIC will be provided with a pedometer and a patient manual which will include information on intermittent claudication, risk factors, walking guidelines, goal setting, problem solving and action planning worksheets and a walking diary.
Other Names:
  • Motivating Structured walking Activity in IC
No Intervention: Usual Care Comparison
Usual NHS care for people with intermittent claudication typically consists of an initial assessment, drug therapy and simple advice to walk provided by a vascular specialist and delivered in the vascular outpatient clinic.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
6 Minute Walk Distance
Time Frame: 3 months
6 Minute Walking Distance (in metres) measured during a self-paced, standardised 6 Minute Walk Test conducted around a level, 100-foot circuit.
3 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
6 Minute Walk Distance (6MWD)
Time Frame: Baseline and 3 months
6 Minute Walking Distance (in metres) measured during a self-paced, standardised 6 Minute Walk Test conducted around a level, 100-foot circuit.
Baseline and 3 months
Self-reported Maximum Walking Distance
Time Frame: Baseline, 3 and 6 months
Single global item
Baseline, 3 and 6 months
Self-Reported Walking Ability
Time Frame: Baseline, 3 and 6 months
Walking Estimated-Limitation Calculated by History (WELCH)
Baseline, 3 and 6 months
Activities of Daily Living
Time Frame: Baseline, 3 and 6 months
Nottingham Extended Activities of Daily Living (NEADL)
Baseline, 3 and 6 months
Health-Related Quality of Life
Time Frame: Baseline, 3 and 6 months
Vascular Quality of Life Questionnaire-6 (VascuQol-6)
Baseline, 3 and 6 months

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Treatment Cognitions
Time Frame: Baseline, 3 and 6 months
Theory of Planned Behaviour Questionnaire
Baseline, 3 and 6 months
Illness Cognitions
Time Frame: Baseline, 3 and 6 months
Brief Illness Perceptions Questionnaire (BIPQ)
Baseline, 3 and 6 months
Walking Adherence
Time Frame: Baseline, 3 and 6 months
Exercise Adherence Rating Scale
Baseline, 3 and 6 months
Resource Use
Time Frame: Baseline, 3 and 6 months
Client Service Receipt Inventory
Baseline, 3 and 6 months
Health Related Quality of Life
Time Frame: Baseline, 3 and 6 months
Euroqol- 5D-5L
Baseline, 3 and 6 months
Pain Free Walking Ability
Time Frame: Baseline and 3 months
Patient-reported pain free walking time (seconds) and distance (metres) during the 6 Minute Walk Test
Baseline and 3 months
Maximal Walking Ability
Time Frame: Baseline and 3 months
The maximum time (seconds) and distance (metres) walked before stopping during a 6 Minute Walk Test
Baseline and 3 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Sanjay Patel, Guy's and St Thomas' NHS Foundation Trust

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 10, 2017

Primary Completion (Anticipated)

November 9, 2020

Study Completion (Anticipated)

January 9, 2021

Study Registration Dates

First Submitted

August 1, 2017

First Submitted That Met QC Criteria

August 1, 2017

First Posted (Actual)

August 3, 2017

Study Record Updates

Last Update Posted (Actual)

December 11, 2019

Last Update Submitted That Met QC Criteria

December 10, 2019

Last Verified

December 1, 2019

More Information

Terms related to this study

Other Study ID Numbers

  • 17/LO/0568
  • R477/0516 (Other Grant/Funding Number: Dunhill Medical Trust)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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