Highlights
- •Behavior-change intervention did not improve physical function after dysvascular transtibial amputation.
- •Walking activity increased and sedentary time decreased after intervention.
- •Low attrition rate and missed sessions indicate positive intervention acceptability.
Abstract
Objective
To determine preliminary efficacy of a home-based behavior-change intervention designed
to promote exercise, walking activity, and disease self-management.
Design
A single-blind, randomized controlled pilot trial.
Setting
One Veterans Administration and 2 regional medical centers.
Participants
A total of 38 participants randomized to behavior-change intervention (n=19) or attention
control (CTL; n=19) group.
Interventions
Weekly 30-minute telephone sessions for 12 weeks with intervention group sessions
focused on health behavior change and CTL group sessions focused on health status
monitoring.
Main Outcome Measures
Physical function, walking activity (steps/d averaged over 10d), and disability were
measured at baseline, 12 weeks (intervention end), and 24 weeks after baseline with
the Timed Up and Go (TUG) test as the primary outcome measure.
Results
The TUG test was not changed from baseline in either group and was not different between
groups after 12 or 24 weeks. Several exploratory outcomes were assessed, including
daily step count, which increased 1135 steps per day in the intervention group compared
to 144 steps per day in the CTL group after 12 weeks (P=.03). Only the intervention group had within-group increase in steps per day from
baseline to 12 (P<.001) and 24 (P=.03) weeks and spent significantly less time in sedentary activity (4.8% decrease)
than the CTL group (0.2% decrease) at 24 weeks (P=.04). There were no other between-group differences in physical function or disability
change over time.
Conclusion
The behavior-change intervention demonstrates promise for increasing walking activity
for people with dysvascular transtibial amputation (TTA). The efficacy of implementing
such intervention in the scope of conventional TTA rehabilitation should be further
studied.
Keywords
List of abbreviations:
CTL (control), DM (diabetes mellitus), PAD (peripheral artery disease), TTA (transtibial amputation), TUG (Timed Up and Go), VA (Veterans Administration), WHODAS 2.0 (World Health Organization Disability Assessment Schedule 2.0)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 07, 2018
Footnotes
Supported by the National Institutes of Health (grant no. K12 HD055931) and/or National Center for Advancing Translational Sciences (grant no. UL1-TR001082).
Clinical Trial Registration No.: NCT01929018.
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
