N/A
N=200
Does Neuromuscular Electrical Stimulation Improve the Absolute Walking Distance in Patients With Intermittent Claudication Compared to Best Available Treatment?
Intermittent Claudication · Peripheral Vascular Diseases
Bottom Line
View on ClinicalTrials.gov: NCT03446027 ↗Enrolled (actual)
200
Serious AEs
12.0%
Results posted
Apr 2024
Primary outcome: Primary: Difference in the Absolute Walking Distance (AWD) at 3 Months Between the Two Treatment Groups — 220.12; 242.97; 327.74; 370.38 Meters — p=0.28
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- NMES (Device)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Imperial College London
- Primary completion
- Mar 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Difference in the Absolute Walking Distance (AWD) at 3 Months Between the Two Treatment Groups |
220.12; 242.97; 327.74; 370.38 | 0.28 |
| SECONDARY Difference in the Initial Claudication Distance (ICD) at 3 Months Between the Two Treatment Groups |
99.10; 105.79; 179.73; 211.45 | 0.23 |
| SECONDARY Quality of Life - Intermittent Claudication Questionnaire (ICQ) |
45.92; 41.98; 41.33; 36.55; 39.27; 35.20 | — |
| SECONDARY Quality of Life - EuroQoL 5D (EQ5D) Health Scale |
45.92; 41.98; 41.33; 36.55; 39.27; 35.20 | — |
| SECONDARY Quality of Life Short Form 36 (SF-36) Physical Component Summary |
36.14; 35.71; 37.42; 38.80; 37.62; 39.47 | — |
| SECONDARY Haemodynamic Assessment - Duplex Ultrasonography - Difference in Volume Flow Between Baseline and 3 Months |
296.89; 300.06; 280.96; 296.77 | 0.516 |
| SECONDARY Haemodynamic Assessment - Laser Doppler Flowmetry (LDF) - Difference in Blood Flux Between Baseline and 12 Months |
2.61; 2.38; 2.79; 2.30; 2.49; 2.50 | — |
| SECONDARY Haemodynamic Assessment - Difference in Ankle Brachial Pressure Index (ABPI) - Left - Between Baseline and 12 Months |
0.76; 0.72; 0.74; 0.72; 0.77; 0.74 | — |
| SECONDARY Health Economic Assessment |
0.6459; 0.6355 | — |
| SECONDARY Compliance With Interventions - Exercise Advice (EA) |
99; 52; 39 | — |
| SECONDARY Device Experience Questionnaire - Ease of Use |
77; 6; 1; 0; 0; 4 | — |
| SECONDARY Quality of Life - EuroQoL 5D (EQ5D) Health Index |
69.61; 69.73; 66.11; 74.02; 68.36; 73.13 | — |
| SECONDARY Quality of Life Short Form 36 (SF-36) Mental Component Summary |
49.75; 52.06; 48.24; 52.99; 49.09; 52.79 | — |
| SECONDARY Haemodynamic Assessment - Duplex Ultrasonography - Difference in Time Average Mean Velocity Between Baseline and 3 Months |
11.28; 12.23; 11.78; 12.47 | — |
| SECONDARY Haemodynamic Assessment - Difference in Ankle Brachial Pressure Index (ABPI) - Right - Between Baseline and 12 Months |
0.77; 0.76; 0.78; 0.77; 0.80; 0.76 | — |
| SECONDARY Compliance With Interventions - Supervised Exercise Therapy (SET) |
69; 19; 11 | — |
| SECONDARY Compliance With Interventions - Neuromuscular Electrical Stimulation (NMES) |
68; 12; 12 | — |
| SECONDARY Device Experience Questionnaire - Reduces Leg Pain |
14; 22; 26; 11; 11; 4 | — |
| SECONDARY Device Experience Questionnaire - Increased Walk Distance |
8; 19; 57; 4 | — |
| SECONDARY Device Experience Questionnaire - Used as Instructed |
2; 82; 4 | — |
| SECONDARY Device Experience Questionnaire - Could Have Used More |
28; 56; 4 | — |
| SECONDARY Device Experience Questionnaire - Used After Treatment |
51; 13; 16; 0; 4; 4 | — |
Summary
Intermittent claudication (IC) is caused by a blockage in the artery of the leg, causing muscle pain. Although some evidence of the efficacy of neuromuscular electrical stimulation (NMES) in the management of patients with IC exists, further high quality research is required. This proposed study is vital to identify the contribution of clinical change using NMES, compared to the current gold standard recommended practice of supervised exercise therapy (SET) and, actual standard of care offered in the majority of the UK and Ireland, including best medical therapy (BMT). The device is expected to increase the walking distance in patients with intermittent claudication (IC), and therefore have a benefit on the same when provided in addition to supervised exercise programmes. It is also expected to cause a reduction in pain symptoms and reduced likelihood of major intervention in late stage peripheral arterial disease (PAD). The principal research objective is to assess the clinical efficacy of a neuromuscular electrical stimulation (NMES) device as an adjunct to the local standard care that is available at the study randomisation sites, in order to improve walking distance in patients with intermittent claudication (IC).
Eligibility Criteria
Inclusion Criteria
- Capacity to provide informed consent
- Aged 18 or above
- Positive Edinburgh Claudication Questionnaire
- ABPI 30mmHg, 40 secs post 1 min treadmill at 10% gradient, 4 km/h)
Exclusion Criteria
- Severe IC requiring invasive intervention as determined by the treating clinician
- Critical limb Ischaemia as defined by the European Consensus Document
- Co-morbid disease prohibiting walking on a treadmill or taking part in supervised exercise therapy.
- Popliteal entrapment syndrome
- Commenced vascular symptom specific medication in previous 6 months e.g. naftidrofuryl oxalate, cilostazol
- Pregnancy
- Any implanted electronic, cardiac or defibrillator device
- Acute deep vein thrombosis
- Broken or bleeding skin including leg ulceration
- Peripheral neuropathy
- Recent lower limb injury or lower back pain
Data sourced from ClinicalTrials.gov (NCT03446027). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.