- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04370327
The Effects of Claudication Severity on Functional Outcomes
The Effects of Claudication Severity on Functional Outcomes in Patients With Intermittent Claudication
Study Overview
Status
Conditions
Detailed Description
Peripheral artery disease (PAD) is a progressive disease and is characterised by atherosclerotic occlusion of the arteries in the lower limbs, resulting in a reduction of blow flow. Globally, it is estimated that 236 million people are living with PAD, with the number of cases increasing by 24% from 2000 to 2010 (Song et al., 2019). A classic symptom of PAD is intermittent claudication (IC), which is characterised by ischemic muscle pain precipitated by exertion and relieved by rest. IC is associated with various comorbidities such as diabetes mellitus, hypertension and dyslipidaemia as well as reductions in physical function, quality of life, and balance. National and international guidelines recommend exercise therapy as first line treatment for patients with IC, advocating two hours per week of a supervised exercise over a three-month period, with patients being encouraged to exercise to the point of maximal pain. Exercise therapy is also a cost-effective option, as a three month programme costs less than a tenth of the cost of angioplasty.
However, despite the plethora of evidence demonstrating the benefits of SEP, less than half of vascular units in the United Kingdom (UK) have access one and patient uptake rates low. A lack of motivation has been shown as one of the primary reasons for poor adherence with claudication pain being suggested as a contributable factor. Indeed, exercise-induced pain has been shown as a major barrier to physical activity in this population and the level of pain prescribed during SEP influences completion rates. When exercise is prescribed at higher levels of pain, completion rates are lower. However, current evidence and guidelines advocate exercising to the point of near maximal pain, despite evidence to the contrary, suggesting that mild- or pain-free exercise improves walking ability. As such, it remains unclear which level of claudication is optimal for improving functional outcomes in patients with IC which can affect patient adherence, clinical practice and exercise prescription. The lack of adequately powered, randomised clinical trials investigating the effects of exercise prescribed at differing levels of claudication pain has also been highlighted in a recent scientific statement from the American Heart Association
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Stefan Birkett, PhD
- Phone Number: 01772 893325
- Email: SBirkett4@uclan.ac.uk
Study Locations
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Preston, United Kingdom
- Recruiting
- School of Sport and and Health Sciences
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- >18 years old
- Resting ankle brachial pressure index (ABPI) <90 mmHg
- Able to walk unaided
- English speaking and able to follow exercise instructions
- Able to provide informed consent
Exclusion Criteria:
- Those who have critical limb threatening ischaemia (rest pain and/or tissue loss)
- Unable to provide consent
- Those undergoing active cancer treatment
- Those presenting with any significant comorbidities or contraindications to exercise testing or training in accordance to the American College of Sports Medicine
- Unstable/uncontrolled coronary heart disease
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Pain Free Exercise (PF)
Patients will be randomised to twice weekly for 24 weeks of pain free exercise in a supervised exercise programme
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Patients will exercise until the onset on claudication (1 on the rating scale)
|
Active Comparator: Moderate Claudication Pain Exercise (MOD-P)
Patients will be randomised to twice weekly for 24 weeks of moderate claudication pain exercise in a supervised exercise programme
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Patients will exercise until they experience moderate claudication pain (2 on the rating scale)
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Active Comparator: Maximal Claudication Pain Exercise (MAX-P)
Patients will be randomised to twice weekly for 24 weeks of maximal claudication pain exercise in a supervised exercise programme
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Patients will exercise until they experience maximal claudication pain (4 on the rating scale)
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Maximal Walking Distance (MWD)
Time Frame: 12 and 24 weeks
|
Metres walked until maximal claudication pain
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12 and 24 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Pain Free Walking Distance (PFWD)
Time Frame: 12 and 24 weeks
|
Metres walked pain free
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12 and 24 weeks
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Adherence
Time Frame: 24 weeks
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Recording the number of training sessions attended and successfully completed
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24 weeks
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Change in Quality of Life
Time Frame: 12 and 24 weeks
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King College 24-item Vascular Quality of life and walking impairment questionnaire
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12 and 24 weeks
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Stefan Birkett, PHD, University of Central Lancashire
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- UCentalLancashirePAD
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Intermittent Claudication
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Mid and South Essex NHS Foundation TrustRecruitingPeripheral Arterial Disease | Claudication, IntermittentUnited Kingdom
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Louis MessinaBioMarin PharmaceuticalRecruitingPeripheral Vascular Diseases | Peripheral Artery Disease | Claudication, IntermittentUnited States
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University Hospital, AngersCompletedPeripheral Artery Disease | Claudication, IntermittentFrance
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Palo Alto Veterans Institute for ResearchSociety for Vascular SurgeryWithdrawnPeripheral Artery Disease | Claudication, Intermittent
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Biotronik AGCompletedSevere Intermittent Claudication | Patients With Symptomatic Critical Limb IschemiaGermany
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University Hospital, EssenStraub Medical AGUnknownPeripheral Arterial Disease | Claudication, IntermittentGermany
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University Hospital, EssenUnknownPeripheral Arterial Disease | Claudication, IntermittentGermany
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Sheffield Teaching Hospitals NHS Foundation TrustUniversity Hospital, Angers; Imperial College London; Sheffield Hallam UniversityCompletedIntermittent ClaudicationUnited Kingdom
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Paradigm SpineCompletedIntermittent Neurogenic Claudication (INC) as a Result of Spinal StenosisNetherlands
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Imperial College LondonTerminatedStandardised Claudication Treadmill TestUnited Kingdom
Clinical Trials on Pain Free Exercise (PF)
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Talita Cumi Ltd.Not yet recruiting
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Liverpool University Hospitals NHS Foundation TrustNot yet recruiting
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Talita Cumi Ltd.Not yet recruitingArthritis | Back Pain | SarcopeniaUnited Kingdom
-
University of FloridaCompletedHealthy | Musculoskeletal PainUnited States
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University of Central FloridaCompleted
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PfizerCompletedTransthyretin Amyloid CardiomyopathyChina
-
Hacettepe UniversityRecruitingPrimary DysmenorrheaTurkey
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Aveiro UniversityFoundation for Science and Technology, PortugalCompletedChronic Neck PainPortugal