Trial Outcomes & Findings for Pain Management and Patient Education for Physical Activity in Intermittent Claudication (PrEPAID) (NCT NCT03204825)

NCT ID: NCT03204825

Last Updated: 2025-10-06

Results Overview

Maximal walking distance on graded treadmill test

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

95 participants

Primary outcome timeframe

Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Results posted on

2025-10-06

Participant Flow

The trial was open for recruitment between August 2017 and March 2020. In total, 1030 people were screened for eligibility; 763 (74%) were ineligible, mainly because they were on the clinic lists due to other conditions e.g., Abdominal Aortic Aneurysm or venous disease (n=343, 45% of ineligible total) or had Critical Limb Ischaemia (CLI) (n=122, 16%). There were 172 individuals that either did not consent to participate or did not respond to invitation.

Participants underwent additional screening prior to randomisation in adherence with the inclusion criteria in the protocol. Thirty-nine participants did not pass screening, 38 (97%) due to having a greater than 20% variance in ACD between the first and second screening visits (one week apart). The other participant who did not pass screening was unable to walk on the treadmill.

Participant milestones

Participant milestones
Measure
Active TENS
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Overall Study
STARTED
14
14
14
14
Overall Study
End of Intervention
12
11
13
13
Overall Study
COMPLETED
13
10
12
10
Overall Study
NOT COMPLETED
1
4
2
4

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Total
n=56 Participants
Total of all reporting groups
Age, Continuous
65.1 years
STANDARD_DEVIATION 9.7 • n=14 Participants
69.1 years
STANDARD_DEVIATION 10.1 • n=14 Participants
64.0 years
STANDARD_DEVIATION 5.5 • n=14 Participants
66.9 years
STANDARD_DEVIATION 8.3 • n=14 Participants
66.3 years
STANDARD_DEVIATION 8.6 • n=56 Participants
Sex: Female, Male
Female
4 Participants
n=14 Participants
1 Participants
n=14 Participants
4 Participants
n=14 Participants
5 Participants
n=14 Participants
14 Participants
n=56 Participants
Sex: Female, Male
Male
10 Participants
n=14 Participants
13 Participants
n=14 Participants
10 Participants
n=14 Participants
9 Participants
n=14 Participants
42 Participants
n=56 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
United Kingdom
14 participants
n=14 Participants
14 participants
n=14 Participants
14 participants
n=14 Participants
14 participants
n=14 Participants
56 participants
n=56 Participants
Body Mass Index
26.4 kg/m^2
STANDARD_DEVIATION 4.7 • n=14 Participants
27.9 kg/m^2
STANDARD_DEVIATION 3.9 • n=14 Participants
30.2 kg/m^2
STANDARD_DEVIATION 5.5 • n=14 Participants
29.4 kg/m^2
STANDARD_DEVIATION 4.3 • n=14 Participants
28.5 kg/m^2
STANDARD_DEVIATION 4.8 • n=56 Participants
Ankle Brachial Pressure Index
0.70 Ratio of systolic BP - UL / LL
STANDARD_DEVIATION 0.21 • n=14 Participants
0.74 Ratio of systolic BP - UL / LL
STANDARD_DEVIATION 0.28 • n=14 Participants
0.67 Ratio of systolic BP - UL / LL
STANDARD_DEVIATION 0.15 • n=14 Participants
0.66 Ratio of systolic BP - UL / LL
STANDARD_DEVIATION 0.14 • n=14 Participants
0.69 Ratio of systolic BP - UL / LL
STANDARD_DEVIATION 0.20 • n=56 Participants
Initial Claudication Distance (ICD)
84.4 Metres
STANDARD_DEVIATION 78.2 • n=14 Participants
126.1 Metres
STANDARD_DEVIATION 165.2 • n=14 Participants
130.2 Metres
STANDARD_DEVIATION 129.6 • n=14 Participants
111.7 Metres
STANDARD_DEVIATION 162.3 • n=14 Participants
113.1 Metres
STANDARD_DEVIATION 135.7 • n=56 Participants
Absolute Claudication Distance (ACD)
243.7 Metres
STANDARD_DEVIATION 240.5 • n=14 Participants
251.3 Metres
STANDARD_DEVIATION 266.5 • n=14 Participants
370.9 Metres
STANDARD_DEVIATION 285.3 • n=14 Participants
318.4 Metres
STANDARD_DEVIATION 321.6 • n=14 Participants
296.1 Metres
STANDARD_DEVIATION 277.3 • n=56 Participants
Average daily number of steps ('000s)
7.5 Steps per day
STANDARD_DEVIATION 7.1 • n=14 Participants
4.9 Steps per day
STANDARD_DEVIATION 2.1 • n=14 Participants
6.0 Steps per day
STANDARD_DEVIATION 2.8 • n=14 Participants
5.1 Steps per day
STANDARD_DEVIATION 3.9 • n=14 Participants
5.9 Steps per day
STANDARD_DEVIATION 4.4 • n=56 Participants
Average daily number of upright events
7.0 Count
STANDARD_DEVIATION 2.9 • n=14 Participants
6.1 Count
STANDARD_DEVIATION 2.7 • n=14 Participants
6.6 Count
STANDARD_DEVIATION 2.9 • n=14 Participants
6.1 Count
STANDARD_DEVIATION 1.8 • n=14 Participants
6.4 Count
STANDARD_DEVIATION 2.5 • n=56 Participants
Average daily number of walking events
50.0 Count
STANDARD_DEVIATION 24.0 • n=14 Participants
50.2 Count
STANDARD_DEVIATION 21.2 • n=14 Participants
53.6 Count
STANDARD_DEVIATION 26.0 • n=14 Participants
46.4 Count
STANDARD_DEVIATION 19.1 • n=14 Participants
50.0 Count
STANDARD_DEVIATION 22.2 • n=56 Participants
Event-based Claudication Index
7.3 Ratio
STANDARD_DEVIATION 2.8 • n=14 Participants
8.9 Ratio
STANDARD_DEVIATION 4.4 • n=14 Participants
8.4 Ratio
STANDARD_DEVIATION 4.3 • n=14 Participants
8.5 Ratio
STANDARD_DEVIATION 6.3 • n=14 Participants
8.3 Ratio
STANDARD_DEVIATION 4.6 • n=56 Participants
SF-36 Physical Component Score
34.4 units on a scale
STANDARD_DEVIATION 7.5 • n=14 Participants
32.5 units on a scale
STANDARD_DEVIATION 8.9 • n=14 Participants
37.3 units on a scale
STANDARD_DEVIATION 5.2 • n=14 Participants
38.1 units on a scale
STANDARD_DEVIATION 6.0 • n=14 Participants
35.6 units on a scale
STANDARD_DEVIATION 7.2 • n=56 Participants
SF-36 Mental Component Score
23.9 units on a scale
STANDARD_DEVIATION 11.3 • n=14 Participants
22.7 units on a scale
STANDARD_DEVIATION 11.7 • n=14 Participants
25.3 units on a scale
STANDARD_DEVIATION 12.7 • n=14 Participants
24.6 units on a scale
STANDARD_DEVIATION 13.9 • n=14 Participants
24.1 units on a scale
STANDARD_DEVIATION 12.2 • n=56 Participants
Intermittent Claudication Questionnaire
53.1 units on a scale
STANDARD_DEVIATION 16.0 • n=14 Participants
53.2 units on a scale
STANDARD_DEVIATION 15.7 • n=14 Participants
52.2 units on a scale
STANDARD_DEVIATION 15.4 • n=14 Participants
47.6 units on a scale
STANDARD_DEVIATION 16.0 • n=14 Participants
51.5 units on a scale
STANDARD_DEVIATION 15.5 • n=56 Participants
Geriatric Depression Scale (short-form)
6.6 units on a scale
STANDARD_DEVIATION 4.2 • n=14 Participants
5.1 units on a scale
STANDARD_DEVIATION 3.9 • n=14 Participants
7.1 units on a scale
STANDARD_DEVIATION 4.6 • n=14 Participants
6.4 units on a scale
STANDARD_DEVIATION 4.7 • n=14 Participants
6.3 units on a scale
STANDARD_DEVIATION 4.3 • n=56 Participants
McGill Pain Questionnaire
30.6 units on a scale
STANDARD_DEVIATION 13.6 • n=14 Participants
22.2 units on a scale
STANDARD_DEVIATION 13.1 • n=14 Participants
31.2 units on a scale
STANDARD_DEVIATION 14.4 • n=14 Participants
29.4 units on a scale
STANDARD_DEVIATION 10.6 • n=14 Participants
28.4 units on a scale
STANDARD_DEVIATION 13.1 • n=56 Participants
Pain Self-Efficacy Questionnaire
35.8 units on a scale
STANDARD_DEVIATION 13.7 • n=14 Participants
42.4 units on a scale
STANDARD_DEVIATION 14.3 • n=14 Participants
36.5 units on a scale
STANDARD_DEVIATION 14.8 • n=14 Participants
35.2 units on a scale
STANDARD_DEVIATION 13.9 • n=14 Participants
37.5 units on a scale
STANDARD_DEVIATION 14.1 • n=56 Participants
Pain intensity (visual analogue scale)
6.3 units on a scale
STANDARD_DEVIATION 2.3 • n=14 Participants
6.2 units on a scale
STANDARD_DEVIATION 2.8 • n=14 Participants
6.6 units on a scale
STANDARD_DEVIATION 2.4 • n=14 Participants
5.5 units on a scale
STANDARD_DEVIATION 2.6 • n=14 Participants
6.2 units on a scale
STANDARD_DEVIATION 2.5 • n=56 Participants
Brief Illness Perception Questionnaire
47.2 units on a scale
STANDARD_DEVIATION 11.9 • n=14 Participants
43.4 units on a scale
STANDARD_DEVIATION 10.1 • n=14 Participants
49.8 units on a scale
STANDARD_DEVIATION 9.7 • n=14 Participants
49.3 units on a scale
STANDARD_DEVIATION 10.4 • n=14 Participants
47.4 units on a scale
STANDARD_DEVIATION 10.6 • n=56 Participants

PRIMARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Maximal walking distance on graded treadmill test

Outcome measures

Outcome measures
Measure
Active TENS
n=12 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=11 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=13 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=13 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Change in Absolute Claudication Distance (ACD) in Meters From Baseline
Change scores from baseline to end of intervention (6 weeks)
-16.8 metres
Interval -62.1 to 28.4
-6.7 metres
Interval -33.8 to 20.5
76.2 metres
Interval 17.0 to 135.4
-0.9 metres
Interval -44.2 to 42.4
Change in Absolute Claudication Distance (ACD) in Meters From Baseline
Change scores from baseline to follow-up (18 weeks)
25.0 metres
Interval -26.8 to 76.7
-17.6 metres
Interval -41.0 to 5.8
89.2 metres
Interval 21.3 to 157.1
-15.1 metres
Interval -64.1 to 33.9

PRIMARY outcome

Timeframe: Recruitment

Measure recruitment rates (ratio of patients who consent to participate to potentially eligible patient recorded via the study screening log

Outcome measures

Outcome measures
Measure
Active TENS
n=267 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Recruitment Rates
95 Participants

PRIMARY outcome

Timeframe: End of study (18 weeks)

Ratio of patients who completed the intervention and outcome assessment to the patient who consented

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Participant Retention Rate
13 Participants
10 Participants
12 Participants
10 Participants

PRIMARY outcome

Timeframe: End of study (18 weeks)

Record defined adverse events in all groups

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Adverse Events
1 Participants
0 Participants
0 Participants
0 Participants

PRIMARY outcome

Timeframe: End of study (18 weeks)

Population: Population described as a whole rather than per-arm as data per arm was not recorded due to blinding. All participants were randomised to receive some type of TENS hence 56 total and 50% of participants received education, hence n=28.

Measure uptake of intervention via log of TENS use and attendance at education session and follow up phone calls

Outcome measures

Outcome measures
Measure
Active TENS
n=56 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=28 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=28 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Uptake of Interventions
39 Participants
27 Participants
18 Participants

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Onset distance of claudication pain on graded treadmill test

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Change in Initial Claudication Distance (ICD) in Meters From Baseline
Change from baseline to end of intervention (6 weeks)
37.8 metres
Interval 5.9 to 69.8
23.2 metres
Interval -17.0 to 163.5
107.6 metres
Interval 37.3 to 178.0
52.2 metres
Interval 5.0 to 99.4
Change in Initial Claudication Distance (ICD) in Meters From Baseline
Change from baseline to follow-up (18 weeks)
55.2 metres
Interval -11.4 to 121.7
77.1 metres
Interval -83.4 to 237.5
122.7 metres
Interval 26.6 to 218.9
54.1 metres
Interval -3.9 to 112.1

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Change in daily number of steps (activpal step counts)

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Change in Daily Number of Steps
Change from baseline to end of intervention (6 weeks)
-1568 steps
Interval -3766.0 to 631.0
-237 steps
Interval -874.0 to 399.0
1076 steps
Interval -758.0 to 2910.0
442 steps
Interval -430.0 to 1314.0
Change in Daily Number of Steps
Change from baseline to follow-up (18 weeks)
-1942 steps
Interval -3239.0 to -646.0
-183 steps
Interval -1048.0 to 683.0
1615 steps
Interval -2425.0 to 5654.0
-1637 steps
Interval -4010.0 to 736.0

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Total number of upright events per day (activpal upright even count)

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Change in Total Number of Upright Events Per Day
Change from baseline to end of intervention (6 weeks)
-1.1 upright events per day
Interval -8.6 to 6.3
-2.3 upright events per day
Interval -6.9 to 2.4
-3.9 upright events per day
Interval -13.5 to 5.6
1.7 upright events per day
Interval -2.3 to 5.7
Change in Total Number of Upright Events Per Day
Change from baseline to follow-up (18 weeks)
-2.1 upright events per day
Interval -8.4 to 4.1
2.5 upright events per day
Interval -3.8 to 8.9
-4.7 upright events per day
Interval -9.2 to -0.2
-3.4 upright events per day
Interval -13.0 to 6.1

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Total number of walking events per day (activpal walking event counts)

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Change in Total Number of Walking Events Per Day
Change from baseline to end of intervention (6 weeks)
-27.7 events per day
Interval -88.4 to 33.0
-22.1 events per day
Interval -65.3 to 21.1
-27.6 events per day
Interval -106.1 to 50.8
16.3 events per day
Interval -46.1 to 78.6
Change in Total Number of Walking Events Per Day
Change from baseline to follow-up (18 weeks)
-53.5 events per day
Interval -99.6 to -7.4
0.1 events per day
Interval -75.8 to 76.1
-36.9 events per day
Interval -98.7 to 25.0
-39.4 events per day
Interval -107.6 to 28.8

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Event-based claudication index (ratio of walking events to upright events) participants undertake in a day.

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Change in Event-based Claudication Index
Change from baseline to end of intervention (6 weeks)
-0.4 calculated ratio index
Interval -1.2 to 0.3
-0.4 calculated ratio index
Interval -1.1 to 0.3
0.9 calculated ratio index
Interval -1.0 to 2.7
-0.2 calculated ratio index
Interval -1.1 to 0.7
Change in Event-based Claudication Index
Change from baseline to follow-up (18 weeks)
-1.2 calculated ratio index
Interval -2.5 to 0.1
-0.7 calculated ratio index
Interval -3.2 to 1.7
0.0 calculated ratio index
Interval -1.0 to 1.0
-0.6 calculated ratio index
Interval -1.0 to -0.2

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Disease specific quality of life questionnaire. ICQ scores range from 0 to 100, with lower scores representing better health status and less impact of claudication

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Intermittent Claudication Questionnaire (ICQ)
Change from baseline to end of intervention (6 weeks)
4.5 units on a scale
Interval -1.3 to 10.2
5.6 units on a scale
Interval 0.3 to 10.8
8.5 units on a scale
Interval 1.7 to 15.3
9.6 units on a scale
Interval 3.5 to 15.7
Intermittent Claudication Questionnaire (ICQ)
Change from baseline to follow-up (18 weeks)
4.4 units on a scale
Interval -0.4 to 9.2
2.3 units on a scale
Interval -3.9 to 8.5
9.3 units on a scale
Interval 1.9 to 16.8
8.0 units on a scale
Interval 3.2 to 12.7

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Generic quality of life questionnaire, physical domain. The SF-36 Physical Component Summary (PCS) ranges from 0-100, with higher scores representing better outcomes.

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Short-Form 36 Questionnaire- Physical Component
Change from baseline to end of intervention (6 weeks)
1.4 units on a scale
Interval -1.4 to 4.3
0.0 units on a scale
Interval -3.3 to 3.3
-5.2 units on a scale
Interval -8.5 to -1.8
-4.5 units on a scale
Interval -8.4 to -0.7
Short-Form 36 Questionnaire- Physical Component
Change from baseline to follow-up (18 weeks)
-0.6 units on a scale
Interval -3.4 to 2.2
1.0 units on a scale
Interval -2.6 to 4.6
-3.7 units on a scale
Interval -5.5 to -1.8
-3.3 units on a scale
Interval -7.2 to 0.7

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Pain quality questionnaire. The MPQ-PRI ranges from 0-78, with lower scores representing less pain and higher scores representing worse pain.

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
McGill Pain Questionnaire (MPQ) Pain Rating Index (PRI)
Change from baseline to end of intervention (6 weeks)
4.3 units on a scale
Interval -0.8 to 9.5
3.5 units on a scale
Interval -4.0 to 11.1
-5.9 units on a scale
Interval -9.9 to -1.9
-6.5 units on a scale
Interval -12.3 to -0.6
McGill Pain Questionnaire (MPQ) Pain Rating Index (PRI)
Change from baseline to follow-up (18 weeks)
2.5 units on a scale
Interval -1.3 to 6.3
2.6 units on a scale
Interval -2.4 to 7.6
-7.4 units on a scale
Interval -11.0 to -3.8
-3.0 units on a scale
Interval -8.1 to 2.1

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Average Pain intensity in the past 7 days. The average pain intensity VAS ranges from 0-100 mm, with lower scores indicating less pain and better outcomes.

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Visual Analogue Scale (VAS)
Change from baseline to end of intervention (6 weeks)
-0.7 units on a scale
Interval -2.2 to 0.8
-1.0 units on a scale
Interval -2.4 to 0.3
-2.0 units on a scale
Interval -3.3 to -0.7
-1.5 units on a scale
Interval -3.1 to 0.0
Visual Analogue Scale (VAS)
Change from baseline to follow-up (18 weeks)
-1.2 units on a scale
Interval -2.7 to 0.2
-1.4 units on a scale
Interval -3.4 to 0.6
-1.8 units on a scale
Interval -3.1 to -0.4
0.1 units on a scale
Interval -1.4 to 1.6

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

The Brief IPQ uses 0-10 scales. Higher scores indicate worse perceptions (greater perceived consequences, concern, emotional impact, chronicity).

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Brief Illness Perception Questionnaire (IPQ)
Change from baseline to end of intervention (6 weeks)
-1.7 units on a scale
Interval -6.8 to 3.5
0.6 units on a scale
Interval -5.0 to 6.3
-7.7 units on a scale
Interval -12.8 to -2.5
-8.1 units on a scale
Interval -15.1 to -1.0
Brief Illness Perception Questionnaire (IPQ)
Change from baseline to follow-up (18 weeks)
-1.5 units on a scale
Interval -6.2 to 3.1
1.0 units on a scale
Interval -5.3 to 7.3
-3.2 units on a scale
Interval -8.9 to 2.4
-5.6 units on a scale
Interval -10.9 to -0.3

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

Depression questionnaire. The GDS-SF ranges 0-15, with higher scores reflecting more depressive symptoms.

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Geriatric Depression Scale (Short Form) (GDS-SF)
Change from baseline to end of intervention (6 weeks)
-1.5 units on a scale
Interval -3.3 to 0.2
-0.8 units on a scale
Interval -3.5 to 2.0
-1.8 units on a scale
Interval -4.0 to 0.3
-1.2 units on a scale
Interval -2.6 to 0.2
Geriatric Depression Scale (Short Form) (GDS-SF)
Change from baseline to follow-up (18 weeks)
-0.9 units on a scale
Interval -3.2 to 1.3
0.2 units on a scale
Interval -2.8 to 3.2
-2.2 units on a scale
Interval -4.8 to 0.4
-1.0 units on a scale
Interval -2.3 to 0.3

SECONDARY outcome

Timeframe: Baseline, 6 weeks (post-intervention), 18 weeks (follow-up)

The PSEQ total score ranges from 0-60, with higher scores indicating better pain self-efficacy and more positive outcomes.

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
Pain Self-Efficacy Questionnaire (PSEQ)
Change from baseline to end of intervention (6 weeks)
1.0 units on a scale
Interval -4.2 to 6.2
0.8 units on a scale
Interval -2.5 to 4.2
5.2 units on a scale
Interval -1.5 to 11.8
6.9 units on a scale
Interval 1.7 to 12.1
Pain Self-Efficacy Questionnaire (PSEQ)
Change from baseline to follow-up (18 weeks)
1.9 units on a scale
Interval -3.7 to 7.6
0.4 units on a scale
Interval -5.5 to 6.3
5.8 units on a scale
Interval -1.8 to 13.4
3.6 units on a scale
Interval -1.9 to 9.1

SECONDARY outcome

Timeframe: Baseline, end of intervention and follow-up

SF-36 Quality of life scale - mental component. The SF-36 MCS ranges 0-100 (or norm-based mean 50, SD 10), with higher scores representing better outcomes.

Outcome measures

Outcome measures
Measure
Active TENS
n=14 Participants
Participants in the TENS groups will be provided with a TENS machine and training at the baseline visit to the Clinical research Facility (CRF). They will be instructed to use it daily as their symptoms require for 6 weeks. The active group will receive High Frequency-TENS (120 Hz, 200µs and a patient-determined intensity of ''strong but comfortable''). Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin.
Placebo TENS
n=14 Participants
Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective
Patient-Centred Education and Placebo TENS
n=14 Participants
Patient-Centred Education : a one-off three-hour workshop of structured group education (4-5 persons in each group) and three 2-weekly phone calls. The aim will be to modify patients' illness beliefs and perceptions about IC/PAD by educating them on disease pathology and management philosophy. After the workshop, each patient will be supported to set goals for walking, develop an action plan regarding how these goals will be met and encouraged to repeat this process for each new walking goal. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking Placebo TENS : Participants will receive the same model, programmed settings and instructions for use as those in the active group except that the device will be set to an ineffective stimulation (120 Hz, 200µs and a patient-determined intensity of '6mA). For the purpose of blinding, participants will be told that different dosages of TENS are being tested, some of which where the stimulation might not be perceivable even though the device is working. Placebo TENS: TENS device use with setting so that the stimulation delivered is ineffective.
Patient-Centred Education + Active TENS
n=14 Participants
Combination of Patient-Centred Education arm and Active TENS arm. Active TENS: TENS is a form of electrical stimulation that provides symptomatic pain relief that is used extensively within the health-care setting. It is a non-invasive modality; packaged in a small, portable unit that is easy to apply via small electrodes placed on the skin. Patient-Centred Education: Group education for patients with peripheral arterial disease and intermittent claudication about their condition, improving patient ownership, and promoting self-managed walking
SF-36 Mental Component Score
Change from baseline to end of intervention (6 weeks)
-2.8 units on a scale
Interval -7.6 to 2.0
0.5 units on a scale
Interval -5.9 to 7.0
-3.0 units on a scale
Interval -9.4 to 3.4
-1.8 units on a scale
Interval -6.8 to 3.2
SF-36 Mental Component Score
Change from baseline to follow-up (18 weeks)
-0.1 units on a scale
Interval -4.4 to 4.3
0.1 units on a scale
Interval -7.8 to 8.0
-2.7 units on a scale
Interval -7.2 to 1.7
-0.4 units on a scale
Interval -4.7 to 4.0

Adverse Events

Active TENS

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Placebo TENS

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Patient-Centred Education + Active TENS

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Patient-Centred Education

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Active TENS
n=14 participants at risk
Active TENS group
Placebo TENS
n=14 participants at risk
Placebo TENS group
Patient-Centred Education + Active TENS
n=14 participants at risk
Patient-Centred Education + Active TENS group
Patient-Centred Education
n=14 participants at risk
Patient-Centred Education group
Skin and subcutaneous tissue disorders
Itching on leg due to TENS electrodes
7.1%
1/14 • Number of events 1 • 24 weeks
7.1%
1/14 • Number of events 1 • 24 weeks
7.1%
1/14 • Number of events 1 • 24 weeks
0.00%
0/14 • 24 weeks

Additional Information

Dr Chris Seenan

University of Stirling

Phone: +441413318151

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place