Improving maximum walking distance in early XXXX : randomised controlled trial.

@entity1 @entity613 @entity3657
The purpose of this study was to determine the impact of increased physical activity and cessation of smoking on the natural history of early @entity3657 . We conducted a randomised controlled trial in Perth, Western Australia, involving 882 @entity1 with early @entity3657 identified via population-based screening using the Edinburgh Claudication Questionnaire and the ankle:brachial index. Members of the control group (n = 441) received "usual care" from their general practitioner while members of the intervention group (n = 441) were allocated to a "stop smoking and keep walking" regime - a combined community-based intervention of cessation of smoking (where applicable) and increased physical activity. Postal follow-up occurred at two and 12 months post-entry into the trial. The main outcome of interest was maximum walking distance. There were no statistically significant differences in the characteristics of the "intervention" and "usual care" groups at recruitment. Follow-up information at two and 12 months was available for 85% and 84% of @entity1 , respectively. At 12 months, more @entity1 allocated to the intervention group had improved their maximum walking distance (23% vs 15%; chi2 = 9.74, df = 2, p = 0.008). In addition, more @entity1 in the intervention group reported walking more than three times per week for recreation (34% vs 25%, p = 0.01). Although not statistically significant, more @entity1 in the intervention group who were smokers when enrolled in the trial had stopped smoking (12% vs 8%, p = 0.43). It is concluded that referral of older @entity1 with @entity613 to established physiotherapy programs in the community can increase levels of physical activity and reduce disability related to @entity3657 . A combination of simple and safe interventions that are readily available in the community through physiotherapists and general practitioners has the potential to improve early @entity3657 .
