Trial Outcomes & Findings for Gamification-Augmented Home-Based Exercise for Peripheral Artery Disease (NCT NCT04536012)

NCT ID: NCT04536012

Last Updated: 2025-02-04

Results Overview

Change in daily step count from baseline to the intervention period (main adjusted model)

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

103 participants

Primary outcome timeframe

16 Weeks

Results posted on

2025-02-04

Participant Flow

Participant milestones

Participant milestones
Measure
Control
Via the Way to Health platform, all patients will receive daily text messages that inform them of their previous day's step count for 24 weeks.
Intervention
Participants have a 4-week ramp-up towards their step goal and are asked to maintain the goal for the rest of the study. They receive daily texts informing them if they met their step goal and biweekly texts to encourage walking for exercise. Participants are entered into a game. Each week they receive 70 points. If the step goal was met they keep their points. If not, they lose 10 points. At the end of the week if they have at least 40 points they move up a level. If not, they drop a level. Participants start in the middle of 5 levels. Participants choose a support partner who gets a weekly email with the participant's progress. We hold a 3-way phone call with the participant and partner to discuss ways they can help the participant meet their goal. Every 8 weeks, we have a follow up call if the participant is stuck in a lower level and restart them back at the middle level. In the follow-up period, participants continue to get a daily text stating if they met their step goal. Gamification and Social Incentives: Participants in the intervention arm will receive gamification and social incentives as part of the intervention. See arm descriptions for more detail.
Overall Study
STARTED
52
51
Overall Study
COMPLETED
51
45
Overall Study
NOT COMPLETED
1
6

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Gamification-Augmented Home-Based Exercise for Peripheral Artery Disease

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Control
n=52 Participants
Via the Way to Health platform, all patients will receive daily text messages that inform them of their previous day's step count for 24 weeks.
Intervention
n=51 Participants
Participants have a 4-week ramp-up towards their step goal and are asked to maintain the goal for the rest of the study. They receive daily texts informing them if they met their step goal and biweekly texts to encourage walking for exercise. Participants are entered into a game. Each week they receive 70 points. If the step goal was met they keep their points. If not, they lose 10 points. At the end of the week if they have at least 40 points they move up a level. If not, they drop a level. Participants start in the middle of 5 levels. Participants choose a support partner who gets a weekly email with the participant's progress. We hold a 3-way phone call with the participant and partner to discuss ways they can help the participant meet their goal. Every 8 weeks, we have a follow up call if the participant is stuck in a lower level and restart them back at the middle level. In the follow-up period, participants continue to get a daily text stating if they met their step goal. Gamification and Social Incentives: Participants in the intervention arm will receive gamification and social incentives as part of the intervention. See arm descriptions for more detail.
Total
n=103 Participants
Total of all reporting groups
Age, Continuous
70 years
STANDARD_DEVIATION 9.1 • n=5 Participants
69.4 years
STANDARD_DEVIATION 8.2 • n=7 Participants
69.7 years
STANDARD_DEVIATION 8.6 • n=5 Participants
Sex: Female, Male
Female
27 Participants
n=5 Participants
22 Participants
n=7 Participants
49 Participants
n=5 Participants
Sex: Female, Male
Male
25 Participants
n=5 Participants
29 Participants
n=7 Participants
54 Participants
n=5 Participants
Race/Ethnicity, Customized
White
42 Participants
n=5 Participants
39 Participants
n=7 Participants
81 Participants
n=5 Participants
Race/Ethnicity, Customized
Black
6 Participants
n=5 Participants
10 Participants
n=7 Participants
16 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Region of Enrollment
United States
52 Participants
n=5 Participants
51 Participants
n=7 Participants
103 Participants
n=5 Participants
Education
Some high school
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Education
High school graduate
7 Participants
n=5 Participants
7 Participants
n=7 Participants
14 Participants
n=5 Participants
Education
Some college
11 Participants
n=5 Participants
22 Participants
n=7 Participants
33 Participants
n=5 Participants
Education
College graduate
32 Participants
n=5 Participants
22 Participants
n=7 Participants
54 Participants
n=5 Participants
Education
Some High School
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Education
High School Graduate
7 Participants
n=5 Participants
7 Participants
n=7 Participants
14 Participants
n=5 Participants
Education
Some College
11 Participants
n=5 Participants
22 Participants
n=7 Participants
33 Participants
n=5 Participants
Education
College Graduate
32 Participants
n=5 Participants
22 Participants
n=7 Participants
54 Participants
n=5 Participants
Marital Status
Single
8 Participants
n=5 Participants
11 Participants
n=7 Participants
19 Participants
n=5 Participants
Marital Status
Married
27 Participants
n=5 Participants
30 Participants
n=7 Participants
57 Participants
n=5 Participants
Marital Status
Other
17 Participants
n=5 Participants
10 Participants
n=7 Participants
27 Participants
n=5 Participants
Annual Household Income
< $50,000
17 Participants
n=5 Participants
18 Participants
n=7 Participants
35 Participants
n=5 Participants
Annual Household Income
$50,000 to $100,000
19 Participants
n=5 Participants
15 Participants
n=7 Participants
34 Participants
n=5 Participants
Annual Household Income
> $100,000
16 Participants
n=5 Participants
18 Participants
n=7 Participants
34 Participants
n=5 Participants
Prior Use of Smartphone or Wearable to Track Steps
35 Participants
n=5 Participants
27 Participants
n=7 Participants
62 Participants
n=5 Participants
Current Smoking
7 Participants
n=5 Participants
4 Participants
n=7 Participants
11 Participants
n=5 Participants
Hypertension
37 Participants
n=5 Participants
46 Participants
n=7 Participants
83 Participants
n=5 Participants
Hyperlipidemia
37 Participants
n=5 Participants
36 Participants
n=7 Participants
73 Participants
n=5 Participants
Diabetes
17 Participants
n=5 Participants
20 Participants
n=7 Participants
37 Participants
n=5 Participants
Prior MI
16 Participants
n=5 Participants
10 Participants
n=7 Participants
26 Participants
n=5 Participants
Stroke
8 Participants
n=5 Participants
4 Participants
n=7 Participants
12 Participants
n=5 Participants
Heart Failure
7 Participants
n=5 Participants
5 Participants
n=7 Participants
12 Participants
n=5 Participants
COPD
7 Participants
n=5 Participants
12 Participants
n=7 Participants
19 Participants
n=5 Participants
Kidney Disease
10 Participants
n=5 Participants
10 Participants
n=7 Participants
20 Participants
n=5 Participants
San Diego Claudication Questionnaire
Classic Claudication
9 Participants
n=5 Participants
12 Participants
n=7 Participants
21 Participants
n=5 Participants
San Diego Claudication Questionnaire
Atypical Leg Pain
26 Participants
n=5 Participants
27 Participants
n=7 Participants
53 Participants
n=5 Participants
San Diego Claudication Questionnaire
No Symptoms
17 Participants
n=5 Participants
12 Participants
n=7 Participants
29 Participants
n=5 Participants
Baseline Daily Step Count
4540 Steps
STANDARD_DEVIATION 2379 • n=5 Participants
4191 Steps
STANDARD_DEVIATION 1627 • n=7 Participants
4367 Steps
STANDARD_DEVIATION 2039 • n=5 Participants
Goal Step Increase
1160 Steps
STANDARD_DEVIATION 2033 • n=5 Participants
1549 Steps
STANDARD_DEVIATION 740 • n=7 Participants
1353 Steps
STANDARD_DEVIATION 1541 • n=5 Participants
BMI
29.4 kg/m^2
STANDARD_DEVIATION 7.2 • n=5 Participants
30.8 kg/m^2
STANDARD_DEVIATION 5.4 • n=7 Participants
30.1 kg/m^2
STANDARD_DEVIATION 6.4 • n=5 Participants

PRIMARY outcome

Timeframe: 16 Weeks

Change in daily step count from baseline to the intervention period (main adjusted model)

Outcome measures

Outcome measures
Measure
Control
n=52 Participants
Via the Way to Health platform, all patients will receive daily text messages that inform them of their previous day's step count for 24 weeks.
Intervention
n=51 Participants
Participants have a 4-week ramp-up towards their step goal and are asked to maintain the goal for the rest of the study. They receive daily texts informing them if they met their step goal and biweekly texts to encourage walking for exercise. Participants are entered into a game. Each week they receive 70 points. If the step goal was met they keep their points. If not, they lose 10 points. At the end of the week if they have at least 40 points they move up a level. If not, they drop a level. Participants start in the middle of 5 levels. Participants choose a support partner who gets a weekly email with the participant's progress. We hold a 3-way phone call with the participant and partner to discuss ways they can help the participant meet their goal. Every 8 weeks, we have a follow up call if the participant is stuck in a lower level and restart them back at the middle level. In the follow-up period, participants continue to get a daily text stating if they met their step goal. Gamification and Social Incentives: Participants in the intervention arm will receive gamification and social incentives as part of the intervention. See arm descriptions for more detail.
Change in Daily Step Count
783 steps per day
Standard Deviation 2441
1770 steps per day
Standard Deviation 2481

SECONDARY outcome

Timeframe: 24 Weeks

Change in daily step count from baseline to the follow-up period (main adjusted model)

Outcome measures

Outcome measures
Measure
Control
n=52 Participants
Via the Way to Health platform, all patients will receive daily text messages that inform them of their previous day's step count for 24 weeks.
Intervention
n=51 Participants
Participants have a 4-week ramp-up towards their step goal and are asked to maintain the goal for the rest of the study. They receive daily texts informing them if they met their step goal and biweekly texts to encourage walking for exercise. Participants are entered into a game. Each week they receive 70 points. If the step goal was met they keep their points. If not, they lose 10 points. At the end of the week if they have at least 40 points they move up a level. If not, they drop a level. Participants start in the middle of 5 levels. Participants choose a support partner who gets a weekly email with the participant's progress. We hold a 3-way phone call with the participant and partner to discuss ways they can help the participant meet their goal. Every 8 weeks, we have a follow up call if the participant is stuck in a lower level and restart them back at the middle level. In the follow-up period, participants continue to get a daily text stating if they met their step goal. Gamification and Social Incentives: Participants in the intervention arm will receive gamification and social incentives as part of the intervention. See arm descriptions for more detail.
Change in Daily Step Count
717 steps per day
Standard Deviation 2410
1786 steps per day
Standard Deviation 2476

OTHER_PRE_SPECIFIED outcome

Timeframe: 24 Weeks

Change in Walking Impairment Questionnaire score from baseline to the end of the intervention period, and from baseline to the end of the follow-up period. Participants are asked to rate the degree of difficulty of various physical activities, ranging from 0 (unable) to 4 (no difficulty). Scores are divided by the maximum number of points and presented on a scale of 0%-100% where 0% indicates they are unable to do the activity and 100% indicates they have no difficulty.

Outcome measures

Outcome measures
Measure
Control
n=52 Participants
Via the Way to Health platform, all patients will receive daily text messages that inform them of their previous day's step count for 24 weeks.
Intervention
n=51 Participants
Participants have a 4-week ramp-up towards their step goal and are asked to maintain the goal for the rest of the study. They receive daily texts informing them if they met their step goal and biweekly texts to encourage walking for exercise. Participants are entered into a game. Each week they receive 70 points. If the step goal was met they keep their points. If not, they lose 10 points. At the end of the week if they have at least 40 points they move up a level. If not, they drop a level. Participants start in the middle of 5 levels. Participants choose a support partner who gets a weekly email with the participant's progress. We hold a 3-way phone call with the participant and partner to discuss ways they can help the participant meet their goal. Every 8 weeks, we have a follow up call if the participant is stuck in a lower level and restart them back at the middle level. In the follow-up period, participants continue to get a daily text stating if they met their step goal. Gamification and Social Incentives: Participants in the intervention arm will receive gamification and social incentives as part of the intervention. See arm descriptions for more detail.
Change in Walking Impairment Questionnaire Score
WIQ Speed
1.7 units on a scale
Interval -5.0 to 8.5
4.8 units on a scale
Interval -2.3 to 11.8
Change in Walking Impairment Questionnaire Score
WIQ Distance
-3.8 units on a scale
Interval -12.2 to 4.5
7.3 units on a scale
Interval -1.5 to 16.0
Change in Walking Impairment Questionnaire Score
WIQ Stair Climbing
6.4 units on a scale
Interval -1.0 to 13.8
9.5 units on a scale
Interval 1.8 to 17.2
Change in Walking Impairment Questionnaire Score
WIQ Overall
1.4 units on a scale
Interval -5.0 to 7.8
5.7 units on a scale
Interval -3.5 to 15.0

OTHER_PRE_SPECIFIED outcome

Timeframe: 24 Weeks

Change in PROMIS (Patient-Reported Outcomes Measurement Information System) mobility, pain interference, and satisfaction with social roles and activities scores from baseline to the end of the intervention period, and from baseline to the end of the follow-up period. In the mobility survey, participants are asked to rate the level of difficulty of various physical activities on a scale from 1 to 5, where 1 means they are unable to do the activity and 5 means they have no difficulty. In the pain interference survey, they are asked to rate the degree to which pain interfered with various activities on a scale from 1 to 5, where 1 indicates pain did not interfere and 5 indicates pain very much interfered. For the satisfaction with social roles, participants are asked to rate how satisfied they are with their ability to perform various activities on a scale of 1-5, where 1 indicates they are not satisfied and 5 indicates they are very satisfied.

Outcome measures

Outcome measures
Measure
Control
n=52 Participants
Via the Way to Health platform, all patients will receive daily text messages that inform them of their previous day's step count for 24 weeks.
Intervention
n=51 Participants
Participants have a 4-week ramp-up towards their step goal and are asked to maintain the goal for the rest of the study. They receive daily texts informing them if they met their step goal and biweekly texts to encourage walking for exercise. Participants are entered into a game. Each week they receive 70 points. If the step goal was met they keep their points. If not, they lose 10 points. At the end of the week if they have at least 40 points they move up a level. If not, they drop a level. Participants start in the middle of 5 levels. Participants choose a support partner who gets a weekly email with the participant's progress. We hold a 3-way phone call with the participant and partner to discuss ways they can help the participant meet their goal. Every 8 weeks, we have a follow up call if the participant is stuck in a lower level and restart them back at the middle level. In the follow-up period, participants continue to get a daily text stating if they met their step goal. Gamification and Social Incentives: Participants in the intervention arm will receive gamification and social incentives as part of the intervention. See arm descriptions for more detail.
Change in PROMIS Mobility, Pain Interference, and Satisfaction With Social Roles and Activities Scores
PROMIS Pain
-2.2 units on a scale
Interval -4.5 to 0.2
-4.7 units on a scale
Interval -7.2 to -2.3
Change in PROMIS Mobility, Pain Interference, and Satisfaction With Social Roles and Activities Scores
PROMIS Social Function
-0.6 units on a scale
Interval -2.8 to 1.6
0.3 units on a scale
Interval -2.0 to 2.6

OTHER_PRE_SPECIFIED outcome

Timeframe: 24 Weeks

Change in SF-36 (36-Item Short Form Survey) physical functioning scale from baseline to the end of the intervention period, and from baseline to the end of the follow-up period. Participants are asked to self-report their health using 8 variously scaled scores. The scales are re-coded to values from 0 to 100, with 0 indicating lowest functioning/well-being and 100 indicating the highest.

Outcome measures

Outcome measures
Measure
Control
n=52 Participants
Via the Way to Health platform, all patients will receive daily text messages that inform them of their previous day's step count for 24 weeks.
Intervention
n=51 Participants
Participants have a 4-week ramp-up towards their step goal and are asked to maintain the goal for the rest of the study. They receive daily texts informing them if they met their step goal and biweekly texts to encourage walking for exercise. Participants are entered into a game. Each week they receive 70 points. If the step goal was met they keep their points. If not, they lose 10 points. At the end of the week if they have at least 40 points they move up a level. If not, they drop a level. Participants start in the middle of 5 levels. Participants choose a support partner who gets a weekly email with the participant's progress. We hold a 3-way phone call with the participant and partner to discuss ways they can help the participant meet their goal. Every 8 weeks, we have a follow up call if the participant is stuck in a lower level and restart them back at the middle level. In the follow-up period, participants continue to get a daily text stating if they met their step goal. Gamification and Social Incentives: Participants in the intervention arm will receive gamification and social incentives as part of the intervention. See arm descriptions for more detail.
Change in SF-36 Physical Functioning Scale
Physical functioning
0.3 units on a scale
Interval -4.4 to 5.0
6.7 units on a scale
Interval 1.8 to 11.6
Change in SF-36 Physical Functioning Scale
Role functioning/physical
5.9 units on a scale
Interval -3.9 to 15.6
12.8 units on a scale
Interval 2.6 to 23.0
Change in SF-36 Physical Functioning Scale
Role functioning/emotional
5.7 units on a scale
Interval -6.2 to 17.6
3.9 units on a scale
Interval -8.5 to 16.3
Change in SF-36 Physical Functioning Scale
Energy/fatigue
3 units on a scale
Interval -1.4 to 7.4
3 units on a scale
Interval -1.6 to 7.7
Change in SF-36 Physical Functioning Scale
Emotional well-being
0.9 units on a scale
Interval -3.3 to 5.0
2.4 units on a scale
Interval -1.9 to 6.7
Change in SF-36 Physical Functioning Scale
Social functioning
7.4 units on a scale
Interval -0.5 to 15.4
2 units on a scale
Interval -6.3 to 10.4
Change in SF-36 Physical Functioning Scale
Pain
3.5 units on a scale
Interval -2.2 to 9.2
10.5 units on a scale
Interval 4.5 to 16.4
Change in SF-36 Physical Functioning Scale
General Health
1.2 units on a scale
Interval -2.5 to 4.8
4.2 units on a scale
Interval 0.4 to 8.0
Change in SF-36 Physical Functioning Scale
Health Change
5.3 units on a scale
Interval -2.4 to 13.0
16.9 units on a scale
Interval 8.8 to 24.9

Adverse Events

Control

Serious events: 3 serious events
Other events: 13 other events
Deaths: 0 deaths

Intervention

Serious events: 6 serious events
Other events: 21 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Control
n=52 participants at risk
Via the Way to Health platform, all patients will receive daily text messages that inform them of their previous day's step count for 24 weeks.
Intervention
n=51 participants at risk
Participants have a 4-week ramp-up towards their step goal and are asked to maintain the goal for the rest of the study. They receive daily texts informing them if they met their step goal and biweekly texts to encourage walking for exercise. Participants are entered into a game. Each week they receive 70 points. If the step goal was met they keep their points. If not, they lose 10 points. At the end of the week if they have at least 40 points they move up a level. If not, they drop a level. Participants start in the middle of 5 levels. Participants choose a support partner who gets a weekly email with the participant's progress. We hold a 3-way phone call with the participant and partner to discuss ways they can help the participant meet their goal. Every 8 weeks, we have a follow up call if the participant is stuck in a lower level and restart them back at the middle level. In the follow-up period, participants continue to get a daily text stating if they met their step goal. Gamification and Social Incentives: Participants in the intervention arm will receive gamification and social incentives as part of the intervention. See arm descriptions for more detail.
Musculoskeletal and connective tissue disorders
Orthopedic
0.00%
0/52 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
9.8%
5/51 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
Cardiac disorders
Cardiovascular
1.9%
1/52 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
2.0%
1/51 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
Product Issues
Fitbit-related
0.00%
0/52 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
0.00%
0/51 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
General disorders
Other
3.8%
2/52 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
0.00%
0/51 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.

Other adverse events

Other adverse events
Measure
Control
n=52 participants at risk
Via the Way to Health platform, all patients will receive daily text messages that inform them of their previous day's step count for 24 weeks.
Intervention
n=51 participants at risk
Participants have a 4-week ramp-up towards their step goal and are asked to maintain the goal for the rest of the study. They receive daily texts informing them if they met their step goal and biweekly texts to encourage walking for exercise. Participants are entered into a game. Each week they receive 70 points. If the step goal was met they keep their points. If not, they lose 10 points. At the end of the week if they have at least 40 points they move up a level. If not, they drop a level. Participants start in the middle of 5 levels. Participants choose a support partner who gets a weekly email with the participant's progress. We hold a 3-way phone call with the participant and partner to discuss ways they can help the participant meet their goal. Every 8 weeks, we have a follow up call if the participant is stuck in a lower level and restart them back at the middle level. In the follow-up period, participants continue to get a daily text stating if they met their step goal. Gamification and Social Incentives: Participants in the intervention arm will receive gamification and social incentives as part of the intervention. See arm descriptions for more detail.
Musculoskeletal and connective tissue disorders
Orthopedic
9.6%
5/52 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
15.7%
8/51 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
Cardiac disorders
Cardiovascular
1.9%
1/52 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
7.8%
4/51 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
Product Issues
Fitbit-related
5.8%
3/52 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
0.00%
0/51 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
General disorders
Other
15.4%
8/52 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.
25.5%
13/51 • 24 weeks
Adverse events were collected via participant reports through study surveys at 16 weeks, and 24-weeks or participant reports to study staff through text, email or phone call.

Additional Information

Alexander C. Fanaroff, MD, MHS

Hospital of the University of Pennsylvania

Phone: 2156157674

Results disclosure agreements

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