‘Walk Walk Walk!’ does not work; barriers to physical activity in patients living with intermittent claudication

Philippa Dall, Ukachukwu Abaraogu, Ebuka Anieto, Chris Seenan
Purpose:

This study aimed to investigate the barriers to physical activity in patients with IC and make a behavioural diagnosis using the Behaviour Change Wheel (BCW) Framework.

Methods:

This study adopted a qualitative approach and utilized an online focus group discussion/workshop to explore patients’ and clinicians’ perceptions of the barriers to physical activity. A purposive sampling technique was used. A total of 13 participants (4 males, 9 females) were involved; 6 patients living with IC, 1 caregiver, 4 vascular surgeons, and 2 physiotherapists were involved in the study. Data from the focus group discussions were coded using NVivo 12. A deductive approach to analysis was taken, which involved data being coded according to pre-defined theories as part of the BCW process.

Results:

Several behavioural factors from multiple Capability, Opportunity, Motivation - Behavior (COM-B) and Theoretical Domains Framework (TDF) components of the BCW influence the physical activity behaviour of patients living with IC. Most of the identified barriers to physical activity were linked to Psychological Capacity and Knowledge (e.g., lack of information), Physical Capability and Physical Skills (e.g., physical limitations due to pain), Physical Opportunity and Environmental context/resources (e.g., poor access to supervised exercise programmes within the NHS service), and Reflective Motivation and Beliefs about consequences (e.g., anxiety about the safety of physical activity).

Conclusion(s):

Several behavioural factors from multiple COM-B and TDF domains influence the physical activity behaviour of patients living with IC. To develop an effective physical activity behaviour change intervention for patients living with PAD/IC, it is important to consider their behavioural diagnosis (barriers mapped to COM-B and TDF models). Future studies should identify intervention functions (part of the BCW framework), and behaviour change techniques that could address these named barriers to physical activity in patients with IC.

Implications:

This behavioural diagnosis would inform the development of an intervention targeted at improving the maintenance of physical activity in individuals with IC. 

Funding acknowledgements:
This study was funded through a PhD Studentship provided by the Glasgow Caledonian University.
Keywords:
Physical Activity
Intermittent Claudication
Behaviour Change Wheel
Primary topic:
Health promotion and wellbeing/healthy ageing/physical activity
Second topic:
Disability and rehabilitation
Third topic:
Non-communicable diseases (NCDs) and risk factors
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Health and Life Sciences Ethics Committee, Glasgow Caledonian University, and West of Scotland Research Ethics Committee 1.
Provide the ethics approval number:
HLS/PSWAHS/22/096, and 23/WS/0069
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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