ClinicalTrials.gg
CompletedNCT03446027NESICUpdated Apr 11, 2024Results posted

Does Neuromuscular Electrical Stimulation Improve the Absolute Walking Distance in Patients With Intermittent Claudication Compared to Best Available Treatment?

An interventional study of NMES in Intermittent Claudication and Peripheral Vascular Diseases, sponsored by Imperial College London. Completed at 11 sites in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-04-11.

Sponsored by Imperial College London · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
200
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study 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).

02

Conditions studied

  • Intermittent Claudication
  • Peripheral Vascular Diseases
03

In context

Intermittent Claudication

309 studies on the registry are indexed under Intermittent Claudication; 46 are open to participants now.

This study's enrollment of 200 is above the median of 74 across 242 interventional studies indexed under Intermittent Claudication.

Browse Intermittent Claudication studies →

Lead sponsor

Imperial College London is the lead sponsor of 843 studies on the registry; 180 are open to participants now.

Of its 9 completed or terminated interventional studies of FDA-regulated products, 6 (67%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Capacity to provide
  • Aged 18 or above
  • Positive Edinburgh Claudication Questionnaire
  • ABPI \<0.9 OR positive stress test (fall in ankle pressure >30mmHg, 40 secs post 1 min treadmill at 10% gradient, 4 km/h)

Exclusion criteria

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
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
200 participants (actual)

Study arms

  • No intervention
    Control

    There will be no change to the local site standard of care for patients with IC attributed to participation in this trial. Those sites with Supervised Exercise Therapy (SET) will continue to provide this intervention as per their normal standard of care and locally agreed protocol.

  • Experimental
    Device

    Local therapy + Neuromuscular Electrical Stimulation (NMES)

    Device: NMES

Interventions

  • DeviceNMES

    NMES device to be used for up to 3 hours daily in 30 minute sessions for 3 months.

06

What researchers measure

Primary outcomes

  1. Difference in the Absolute Walking Distance (AWD) at 3 Months Between the Two Treatment Groups

    Measured by treadmill testing. Absolute walking distance in meters at baseline and 3 months

    Time frame: 3 months

Secondary outcomes

  1. Difference in the Initial Claudication Distance (ICD) at 3 Months Between the Two Treatment Groups

    Measured by treadmill testing. ICD in meters at baseline and 3 months

    Time frame: 3 months

  2. Quality of Life - Intermittent Claudication Questionnaire (ICQ)

    Patient questionnaire. Used to assess change in disease-specific QoL.

    Time frame: Baseline, 3 months, 6 months, 12 months

  3. Quality of Life - EuroQoL 5D (EQ5D) Health Scale

    Patient questionnaire. Used to assess the generic QoL and will allow economic assessment based on intervention and score improvement.

    Time frame: Baseline, 3 month, 6 month and 12 months

  4. Quality of Life Short Form 36 (SF-36) Physical Component Summary

    Patient questionnaire. Used to assess the generic QoL and will allow economic assessment based on intervention and score improvement.

    Time frame: Baseline, 3 month, 6 month and 12 months

  5. Haemodynamic Assessment - Duplex Ultrasonography - Difference in Volume Flow Between Baseline and 3 Months

    Using an arterial ultrasound probe and pre-set volume flow algorithms on a duplex ultrasound machine, flow within the common femoral artery (CFA), of the most affected limb, will be measured, approximately 5cm below the mid-inguinal point at the groin. Measures include volume flow (VF, cc/min) to assess whether using the device increases this measurement.

    Time frame: 3 months

  6. Haemodynamic Assessment - Laser Doppler Flowmetry (LDF) - Difference in Blood Flux Between Baseline and 12 Months

    The single fibre laser optical probe of the LDF machine will be positioned on the dorsal aspect of the foot using single use adhesive pads. Flux, as a measure of superficial skin blood flow will be measured to assess whether using the device increases this measurement.

    Time frame: Baseline, 3 month, 6 month and 12 months

  7. Haemodynamic Assessment - Difference in Ankle Brachial Pressure Index (ABPI) - Left - Between Baseline and 12 Months

    The brachial blood pressure from the right arm using a manual blood pressure monitor cuff and Doppler will be recorded after 5 minutes of resting supine on a couch. The systolic blood pressure of the anterior tibial artery and posterior tibial artery at the ankle will also be recorded using the cuff and Dopplermethod. The ratio of the systolic brachial and ankle pressures will form the ABPI measurement.

    Time frame: Baseline, 3 month, 6 month and 12 months

  8. Health Economic Assessment

    The economic analyses will compare local therapy (supervised exercise therapy (SET) or exercise advice (EA) only) versus the intervention (local therapy + Neuromuscular Electrical Stimulation, NMES) in patients with Intermittent Claudication. The analyses will be based on a (i) patient level in-trial cost-effectiveness analysis, (ii) a decision model and (iii) budget impact assessment. The in-trial analysis will calculate quality-adjusted life years (QALYs) over the one year time horizon of the trial.

    Time frame: Baseline, 3 month, 6 month and 12 months

  9. Compliance With Interventions - Exercise Advice (EA)

    Comparison of compliance with exercise advice as per local standard of care.

    Time frame: 3 months

  10. Device Experience Questionnaire - Ease of Use

    To report ease of device use and suggest any developments.

    Time frame: 3 months

  11. Quality of Life - EuroQoL 5D (EQ5D) Health Index

    Patient questionnaire. Used to assess the generic QoL and will allow economic assessment based on intervention and score improvement.

    Time frame: Baseline, 3 months, 6 months, 12 months

  12. Quality of Life Short Form 36 (SF-36) Mental Component Summary

    Patient questionnaire. Used to assess the generic QoL and will allow economic assessment based on intervention and score improvement.

    Time frame: Baseline, 3 months, 6 months, 12 months

  13. Haemodynamic Assessment - Duplex Ultrasonography - Difference in Time Average Mean Velocity Between Baseline and 3 Months

    Using an arterial ultrasound probe and pre-set volume flow algorithms on a duplex ultrasound machine, flow within the common femoral artery (CFA), of the most affected limb, will be measured, approximately 5cm below the mid-inguinal point at the groin. Measures include time-averaged mean volume (TAMV, cm/s) to assess whether using the device increases this measurement.

    Time frame: 3 months

  14. Haemodynamic Assessment - Difference in Ankle Brachial Pressure Index (ABPI) - Right - Between Baseline and 12 Months

    The brachial blood pressure from the right arm using a manual blood pressure monitor cuff and Doppler will be recorded after 5 minutes of resting supine on a couch. The systolic blood pressure of the anterior tibial artery and posterior tibial artery at the ankle will also be recorded using the cuff and Dopplermethod. The ratio of the systolic brachial and ankle pressures will form the ABPI measurement.

    Time frame: Baseline, 3 months, 6 months and 12 months

  15. Compliance With Interventions - Supervised Exercise Therapy (SET)

    Comparison of compliance with SET classes.

    Time frame: 3 months

  16. Compliance With Interventions - Neuromuscular Electrical Stimulation (NMES)

    Compliance with NMES device. NMES compliance data collected from the data logger fitted to device and patient diary will be combined to report overall compliance.

    Time frame: 3 months

  17. Device Experience Questionnaire - Reduces Leg Pain

    To report ease of device use and suggest any developments.

    Time frame: 3 months

  18. Device Experience Questionnaire - Increased Walk Distance

    To report ease of device use and suggest any developments.

    Time frame: 3 months

  19. Device Experience Questionnaire - Used as Instructed

    To report ease of device use and suggest any developments.

    Time frame: 3 months

  20. Device Experience Questionnaire - Could Have Used More

    To report ease of device use and suggest any developments.

    Time frame: 3 months

  21. Device Experience Questionnaire - Used After Treatment

    To report ease of device use and suggest any developments.

    Time frame: 3 months

Other outcomes

  1. Sub-group Analysis 1 - Difference in Absolute Walking Difference Between Baseline and 3 Months SET Sites vs Non-SET Sites

    Subgroup analysis 1: Right censored Tobit regression model for AWD at 3 months to assess the effects SET sites vs non-SET sites (NMES+SET+BMT \& SET+BMT vs NMES+BMT \& BMT).

    Time frame: 3 months

  2. Sub-group Analysis 2 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+SET+BMT vs SET+BMT)

    Subgroup analysis 2: Right censored Tobit Regression model for AWD at 3 months to assess the effects of NMES in the SET sites (NMES+SET+BMT vs SET+BMT).

    Time frame: 3 months

  3. Sub-group Analysis 3 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+BMT vs BMT)

    Subgroup analysis 3: Right censored Tobit regression model for the AWD at 3 months to assess the effects of NMES in the non-SET sites (NMES+BMT vs BMT).

    Time frame: 3 months

  4. Sub-group Analysis 4 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+BMT vs. SET+BMT)

    Subgroup analysis 4: Right censored Tobit regression model for AWD at 3 months to assess the effects of (NMES+BMT) has a similar effect as (SET+BMT).

    Time frame: 3 months

  5. Sub-group Analysis 5 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+SET+BMT vs. NMES+BMT)

    Subgroup analysis 5: Determine if (NMES+SET+BMT) is more effective than (NMES+BMT).

    Time frame: 3 months

07

Results

Posted Apr 10, 2024
Limitations and caveats
We did not stratify by baseline absolute walking distance AWD for the primary outcome analysis. Only 160 patients had analysable primary outcome data due to missing treadmill data. Absence of a sham device comparator.

Participant flow

Participant flow — Overall Study
MilestoneControlDevice
Started10298
Completed7880
Not completed2418

Outcome measures

PrimaryDifference in the Absolute Walking Distance (AWD) at 3 Months Between the Two Treatment Groups

Measured by treadmill testing. Absolute walking distance in meters at baseline and 3 months

Time frame:
3 months
Reported as:
Mean · Meters
Difference in the Absolute Walking Distance (AWD) at 3 Months Between the Two Treatment Groups
MetersControlDevice
Baseline220.12 ± 148.27242.97 ± 187.08
3 months327.74 ± 222.65370.38 ± 251.38
Statistical analysis
  • Control vs Device · Tobit Regression · p = 0.28 · Square root transformation: 0.835 · 95% CI -0.674 to 2.343
SecondaryDifference in the Initial Claudication Distance (ICD) at 3 Months Between the Two Treatment Groups

Measured by treadmill testing. ICD in meters at baseline and 3 months

Time frame:
3 months
Reported as:
Mean · Meters
Difference in the Initial Claudication Distance (ICD) at 3 Months Between the Two Treatment Groups
MetersControlDevice
Baseline99.10 ± 77.06105.79 ± 106.27
3 months179.73 ± 147.03211.45 ± 181.83
Statistical analysis
  • Control vs Device · Right censored, Tobit Regression · p = 0.23 · Square root transformation: 0.972 · 95% CI -0.600 to 2.546
SecondaryQuality of Life - Intermittent Claudication Questionnaire (ICQ)

Patient questionnaire. Used to assess change in disease-specific QoL.

Time frame:
Baseline, 3 months, 6 months, 12 months
Reported as:
Mean · score on a scale
Quality of Life - Intermittent Claudication Questionnaire (ICQ)
score on a scaleControlDevice
Baseline45.92 ± 13.0941.98 ± 13.26
3 months41.33 ± 14.5236.55 ± 13.86
6 months39.27 ± 14.5135.20 ± 15.07
12 months36.21 ± 16.4536.99 ± 17.38
SecondaryQuality of Life - EuroQoL 5D (EQ5D) Health Scale

Patient questionnaire. Used to assess the generic QoL and will allow economic assessment based on intervention and score improvement.

Time frame:
Baseline, 3 month, 6 month and 12 months
Reported as:
Mean · score on a scale
Quality of Life - EuroQoL 5D (EQ5D) Health Scale
score on a scaleControlDevice
Baseline45.92 ± 13.0941.98 ± 13.26
3 months41.33 ± 14.5236.55 ± 13.86
6 months39.27 ± 14.5135.20 ± 15.07
12 months36.21 ± 16.4536.99 ± 17.38
SecondaryQuality of Life Short Form 36 (SF-36) Physical Component Summary

Patient questionnaire. Used to assess the generic QoL and will allow economic assessment based on intervention and score improvement.

Time frame:
Baseline, 3 month, 6 month and 12 months
Reported as:
Mean · score on a scale
Quality of Life Short Form 36 (SF-36) Physical Component Summary
score on a scaleControlDevice
Baseline36.14 ± 7.9035.71 ± 8.22
3 months37.42 ± 8.4838.80 ± 8.87
6 months37.62 ± 9.8539.47 ± 9.74
12 months39.46 ± 9.4038.16 ± 9.98
SecondaryHaemodynamic Assessment - Duplex Ultrasonography - Difference in Volume Flow Between Baseline and 3 Months

Using an arterial ultrasound probe and pre-set volume flow algorithms on a duplex ultrasound machine, flow within the common femoral artery (CFA), of the most affected limb, will be measured, approximately 5cm below the mid-inguinal point at the groin. Measures include volume flow (VF, cc/min) to assess whether using the device increases this measurement.

Time frame:
3 months
Reported as:
Mean · cc/min
Haemodynamic Assessment - Duplex Ultrasonography - Difference in Volume Flow Between Baseline and 3 Months
cc/minControlDevice
Baseline296.89 ± 198.40300.06 ± 155.10
3 months280.96 ± 179.03296.77 ± 146.30
Statistical analysis
  • Control vs Device · Regression, Linear · p = 0.516 · Linear regression: 0.483 · 95% CI -0.984 to 1.950
SecondaryHaemodynamic Assessment - Laser Doppler Flowmetry (LDF) - Difference in Blood Flux Between Baseline and 12 Months

The single fibre laser optical probe of the LDF machine will be positioned on the dorsal aspect of the foot using single use adhesive pads. Flux, as a measure of superficial skin blood flow will be measured to assess whether using the device increases this measurement.

Time frame:
Baseline, 3 month, 6 month and 12 months
Reported as:
Mean · Unitless
Haemodynamic Assessment - Laser Doppler Flowmetry (LDF) - Difference in Blood Flux Between Baseline and 12 Months
UnitlessTreatmentControl
Baseline2.61 ± 0.582.38 ± 0.56
3 months2.79 ± 0.692.30 ± 0.65
6 months2.49 ± 0.572.50 ± 0.62
12 months2.64 ± 0.612.53 ± 0.56
SecondaryHaemodynamic Assessment - Difference in Ankle Brachial Pressure Index (ABPI) - Left - Between Baseline and 12 Months

The brachial blood pressure from the right arm using a manual blood pressure monitor cuff and Doppler will be recorded after 5 minutes of resting supine on a couch. The systolic blood pressure of the anterior tibial artery and posterior tibial artery at the ankle will also be recorded using the cuff and Dopplermethod. The ratio of the systolic brachial and ankle pressures will form the ABPI measurement.

Time frame:
Baseline, 3 month, 6 month and 12 months
Reported as:
Mean · Ratio
Haemodynamic Assessment - Difference in Ankle Brachial Pressure Index (ABPI) - Left - Between Baseline and 12 Months
RatioControlDevice
Baseline0.76 ± 0.210.72 ± 0.18
3 months0.74 ± 0.230.72 ± 0.21
6 months0.77 ± 0.220.74 ± 0.2
12 months0.79 ± 0.230.74 ± 0.22
SecondaryHealth Economic Assessment

The economic analyses will compare local therapy (supervised exercise therapy (SET) or exercise advice (EA) only) versus the intervention (local therapy + Neuromuscular Electrical Stimulation, NMES) in patients with Intermittent Claudication. The analyses will be based on a (i) patient level in-trial cost-effectiveness analysis, (ii) a decision model and (iii) budget impact assessment. The in-trial analysis will calculate quality-adjusted life years (QALYs) over the one year time horizon of the trial.

Time frame:
Baseline, 3 month, 6 month and 12 months
Reported as:
Mean · QALY
Health Economic Assessment
QALYTreatmentControl
Health Economic Assessment0.6459 (0.6032 to 0.6886)0.6355 (0.5992 to 0.6718)
SecondaryCompliance With Interventions - Exercise Advice (EA)

Comparison of compliance with exercise advice as per local standard of care.

Time frame:
3 months
Reported as:
Count of participants · Participants
Compliance With Interventions - Exercise Advice (EA)
ParticipantsCompliance to Exercise Advice
Complier99
Non-complier52
Missing39
SecondaryDevice Experience Questionnaire - Ease of Use

To report ease of device use and suggest any developments.

Time frame:
3 months
Reported as:
Count of participants · Participants
Device Experience Questionnaire - Ease of Use
ParticipantsDevice Arm
1 Very easy77
26
31
40
5 Very difficult0
Missing4
SecondaryQuality of Life - EuroQoL 5D (EQ5D) Health Index

Patient questionnaire. Used to assess the generic QoL and will allow economic assessment based on intervention and score improvement.

Time frame:
Baseline, 3 months, 6 months, 12 months
Reported as:
Mean · score on a scale
Quality of Life - EuroQoL 5D (EQ5D) Health Index
score on a scaleControlDevice
Baseline69.61 ± 17.6969.73 ± 18.03
3 months66.11 ± 21.0974.02 ± 15.13
6 months68.36 ± 20.8573.13 ± 19.32
12 months68.03 ± 19.6170.40 ± 20.98
SecondaryQuality of Life Short Form 36 (SF-36) Mental Component Summary

Patient questionnaire. Used to assess the generic QoL and will allow economic assessment based on intervention and score improvement.

Time frame:
Baseline, 3 months, 6 months, 12 months
Reported as:
Mean · score on a scale
Quality of Life Short Form 36 (SF-36) Mental Component Summary
score on a scaleControlDevice
Baseline49.75 ± 12.4752.06 ± 11.61
3 months48.24 ± 13.1552.99 ± 10.05
6 months49.09 ± 10.9052.79 ± 10.73
12 months48.90 ± 12.2452.62 ± 11.68
SecondaryHaemodynamic Assessment - Duplex Ultrasonography - Difference in Time Average Mean Velocity Between Baseline and 3 Months

Using an arterial ultrasound probe and pre-set volume flow algorithms on a duplex ultrasound machine, flow within the common femoral artery (CFA), of the most affected limb, will be measured, approximately 5cm below the mid-inguinal point at the groin. Measures include time-averaged mean volume (TAMV, cm/s) to assess whether using the device increases this measurement.

Time frame:
3 months
Reported as:
Mean · cm/s
Haemodynamic Assessment - Duplex Ultrasonography - Difference in Time Average Mean Velocity Between Baseline and 3 Months
cm/sControlDevice
Baseline11.28 ± 5.6412.23 ± 6.47
3 months11.78 ± 5.7712.47 ± 5.39
SecondaryHaemodynamic Assessment - Difference in Ankle Brachial Pressure Index (ABPI) - Right - Between Baseline and 12 Months

The brachial blood pressure from the right arm using a manual blood pressure monitor cuff and Doppler will be recorded after 5 minutes of resting supine on a couch. The systolic blood pressure of the anterior tibial artery and posterior tibial artery at the ankle will also be recorded using the cuff and Dopplermethod. The ratio of the systolic brachial and ankle pressures will form the ABPI measurement.

Time frame:
Baseline, 3 months, 6 months and 12 months
Reported as:
Mean · Ratio
Haemodynamic Assessment - Difference in Ankle Brachial Pressure Index (ABPI) - Right - Between Baseline and 12 Months
RatioControlDevice
Baseline0.77 ± 0.220.76 ± 0.21
3 months0.78 ± 0.220.77 ± 0.21
6 months0.80 ± 0.280.76 ± 0.23
12 months0.79 ± 0.230.78 ± 0.21
SecondaryCompliance With Interventions - Supervised Exercise Therapy (SET)

Comparison of compliance with SET classes.

Time frame:
3 months
Reported as:
Count of participants · Participants
Compliance With Interventions - Supervised Exercise Therapy (SET)
ParticipantsCompliance to Supervised Exercise Therapy (SET)
Complier69
Non-complier19
Missing11
SecondaryCompliance With Interventions - Neuromuscular Electrical Stimulation (NMES)

Compliance with NMES device. NMES compliance data collected from the data logger fitted to device and patient diary will be combined to report overall compliance.

Time frame:
3 months
Reported as:
Count of participants · Participants
Compliance With Interventions - Neuromuscular Electrical Stimulation (NMES)
ParticipantsCompliance to Neuromuscular Electrical Stimulation (NMES)
Complier68
Non-complier12
Missing12
SecondaryDevice Experience Questionnaire - Reduces Leg Pain

To report ease of device use and suggest any developments.

Time frame:
3 months
Reported as:
Count of participants · Participants
Device Experience Questionnaire - Reduces Leg Pain
ParticipantsDevice Arm
1-Yes, a lot14
222
326
411
5-Not at all11
Missing4
SecondaryDevice Experience Questionnaire - Increased Walk Distance

To report ease of device use and suggest any developments.

Time frame:
3 months
Reported as:
Count of participants · Participants
Device Experience Questionnaire - Increased Walk Distance
ParticipantsDevice Arm
No8
No change19
Yes57
Missing4
SecondaryDevice Experience Questionnaire - Used as Instructed

To report ease of device use and suggest any developments.

Time frame:
3 months
Reported as:
Count of participants · Participants
Device Experience Questionnaire - Used as Instructed
ParticipantsDevice Arm
No2
Yes82
Missing4
SecondaryDevice Experience Questionnaire - Could Have Used More

To report ease of device use and suggest any developments.

Time frame:
3 months
Reported as:
Count of participants · Participants
Device Experience Questionnaire - Could Have Used More
ParticipantsDevice Arm
No28
Yes56
Missing4
SecondaryDevice Experience Questionnaire - Used After Treatment

To report ease of device use and suggest any developments.

Time frame:
3 months
Reported as:
Count of participants · Participants
Device Experience Questionnaire - Used After Treatment
ParticipantsDevice Arm
1-Yes, a lot51
213
316
40
5-Not at all4
Missing4
Other pre-specifiedSub-group Analysis 1 - Difference in Absolute Walking Difference Between Baseline and 3 Months SET Sites vs Non-SET Sites

Subgroup analysis 1: Right censored Tobit regression model for AWD at 3 months to assess the effects SET sites vs non-SET sites (NMES+SET+BMT \& SET+BMT vs NMES+BMT \& BMT).

Time frame:
3 months
Reported as:
Number · Units
Sub-group Analysis 1 - Difference in Absolute Walking Difference Between Baseline and 3 Months SET Sites vs Non-SET Sites
UnitsTreatment Effect in SET Sites vs Non-SET Sites
Sub-group Analysis 1 - Difference in Absolute Walking Difference Between Baseline and 3 Months SET Sites vs Non-SET Sites3.205 (1.689 to 4.720)
Other pre-specifiedSub-group Analysis 2 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+SET+BMT vs SET+BMT)

Subgroup analysis 2: Right censored Tobit Regression model for AWD at 3 months to assess the effects of NMES in the SET sites (NMES+SET+BMT vs SET+BMT).

Time frame:
3 months
Reported as:
Number · Units
Sub-group Analysis 2 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+SET+BMT vs SET+BMT)
UnitsTreatment Effect of NMES in the SET Sites
Sub-group Analysis 2 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+SET+BMT vs SET+BMT)1.724 (-0.560 to 4.008)
Other pre-specifiedSub-group Analysis 3 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+BMT vs BMT)

Subgroup analysis 3: Right censored Tobit regression model for the AWD at 3 months to assess the effects of NMES in the non-SET sites (NMES+BMT vs BMT).

Time frame:
3 months
Reported as:
Number · Units
Sub-group Analysis 3 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+BMT vs BMT)
UnitsTreatment Effect of NMES in the Non-SET Sites
Sub-group Analysis 3 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+BMT vs BMT)-0.090 (-2.014 to 1.833)
Other pre-specifiedSub-group Analysis 4 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+BMT vs. SET+BMT)

Subgroup analysis 4: Right censored Tobit regression model for AWD at 3 months to assess the effects of (NMES+BMT) has a similar effect as (SET+BMT).

Time frame:
3 months
Reported as:
Number · Units
Sub-group Analysis 4 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+BMT vs. SET+BMT)
UnitsInvestigate if the Treatment Effect of (NMES+BMT) Has a Similar Effect as (SET+BMT)
Sub-group Analysis 4 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+BMT vs. SET+BMT)-2.419 (-4.324 to -0.513)
Other pre-specifiedSub-group Analysis 5 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+SET+BMT vs. NMES+BMT)

Subgroup analysis 5: Determine if (NMES+SET+BMT) is more effective than (NMES+BMT).

Time frame:
3 months
Reported as:
Number · Units
Sub-group Analysis 5 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+SET+BMT vs. NMES+BMT)
UnitsDetermine if (NMES+SET+BMT) is More Effective Than (NMES+BMT)
Sub-group Analysis 5 - Difference in Absolute Walking Difference Between Baseline and 3 Months (NMES+SET+BMT vs. NMES+BMT)4.248 (2.229 to 6.268)
Post-hocSub-group Analysis 6 - Difference in Absolute Walking Difference Between Baseline and 3 Months (BMT vs. NMES+SET+BMT)

Subgroup analysis 6: Determine if (BMT) is more effective than (NMES+SET+BMT).

Time frame:
3 months
Reported as:
Number · Units
Sub-group Analysis 6 - Difference in Absolute Walking Difference Between Baseline and 3 Months (BMT vs. NMES+SET+BMT)
UnitsDetermine if (BMT) is More Effective Than (NMES+SET+BMT)
Sub-group Analysis 6 - Difference in Absolute Walking Difference Between Baseline and 3 Months (BMT vs. NMES+SET+BMT)-4.098 (-6.560 to -1.636)
Post-hocSub-group Analysis 7 - Difference in Absolute Walking Difference Between Baseline and 3 Months (BMT vs. BMT+SET)

Subgroup analysis 7: Determine if (BMT) is more effective than (BMT+SET). The sample size in this group is N=80 (n=31 in BMT and n=49 in BMT+SET).

Time frame:
3 months
Reported as:
Number · Units
Sub-group Analysis 7 - Difference in Absolute Walking Difference Between Baseline and 3 Months (BMT vs. BMT+SET)
UnitsDetermine if (BMT) is More Effective Than (BMT+SET)
Sub-group Analysis 7 - Difference in Absolute Walking Difference Between Baseline and 3 Months (BMT vs. BMT+SET)2.341 (0.054 to 4.629)
Post-hocPost-hoc: Difference in Absolute Walking Difference for Patients Who Walked a Short Distance at Baseline (Baseline to 3 Months)

Right censored Tobit regression model for Absolute Walking Distance (AWD) at 3 months for patients who walked a short distance at baseline in the ITT population (N=40). The AWD at baseline was divided into three strati: Short, Medium and Long distances (set at \<25%, 25%-75% and \>75% respectively) using the descriptive statistics - short distance defined as \<100m.

Time frame:
3 months
Reported as:
Number · Units
Post-hoc: Difference in Absolute Walking Difference for Patients Who Walked a Short Distance at Baseline (Baseline to 3 Months)
UnitsTreatment Versus Control: Primary Outcome for Patients Who Walked a Short Distance at Baseline
Post-hoc: Difference in Absolute Walking Difference for Patients Who Walked a Short Distance at Baseline (Baseline to 3 Months)0.426 (-3.499 to 4.351)
Post-hocPost-hoc: Difference in Absolute Walking Difference for Patients Who Walked a Medium Distance at Baseline (Baseline to 3 Months)

Right censored Tobit regression model for Absolute Walking Distance (AWD) at 3 months for patients who walked a medium distance at baseline in the ITT population (N=80). The AWD at baseline was divided into three strati: Short, Medium and Long distances (set at \<25%, 25%-75% and \>75% respectively) using the descriptive statistics - medium distance defined as between 100m and 340m.

Time frame:
3 months
Reported as:
Number · Units
Post-hoc: Difference in Absolute Walking Difference for Patients Who Walked a Medium Distance at Baseline (Baseline to 3 Months)
UnitsTreatment Versus Control: Primary Outcome for Patients Who Walked a Medium Distance at Baseline
Post-hoc: Difference in Absolute Walking Difference for Patients Who Walked a Medium Distance at Baseline (Baseline to 3 Months)0.215 (-1.805 to 2.235)
Post-hocPost-hoc: Difference in Absolute Walking Difference for Patients Who Walked a Long Distance at Baseline (Baseline to 3 Months)

Right censored Tobit regression model for Absolute Walking Distance (AWD) at 3 months for patients who walked a long distance at baseline in the ITT population (N=40). The AWD at baseline was divided into three strati: Short, Medium and Long distances (set at \<25%, 25%-75% and \>75% respectively) using the descriptive statistics - long distance defined as \>340m.

Time frame:
3 months
Reported as:
Number · Units
Post-hoc: Difference in Absolute Walking Difference for Patients Who Walked a Long Distance at Baseline (Baseline to 3 Months)
UnitsTreatment Versus Control: Primary Outcome for Patients Who Walked a Long Distance at Baseline
Post-hoc: Difference in Absolute Walking Difference for Patients Who Walked a Long Distance at Baseline (Baseline to 3 Months)2.877 (0.506 to 5.248)

Adverse events

Collected over Adverse event data was collected during the full study duration (12 months).. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Control2/102 (2%)13/102 (12.7%)44/102 (43.1%)
Device2/98 (2%)11/98 (11.2%)47/98 (48%)
Most frequent serious events
Showing 10 of 38
Most frequent serious events
EventControlDevice
DiarrhoeaGastrointestinal disorders1/1022/98
Abdominal painGastrointestinal disorders0/1022/98
Peripheral arterial occlusive diseaseVascular disorders1/1021/98
Acute myocardial infarctionCardiac disorders0/1021/98
Cardiac failure acuteCardiac disorders0/1021/98
Chest painCardiac disorders1/1021/98
Groin abscessInfections and infestations0/1021/98
Peripheral endarterectomySurgical and medical procedures0/1021/98
UrosepsisInfections and infestations0/1021/98
vomitingGastrointestinal disorders1/1021/98
Most frequent other events
Showing 10 of 87
Most frequent other events
EventControlDevice
Back painMusculoskeletal and connective tissue disorders4/1026/98
Lower respiratory tract infectionInfections and infestations5/1024/98
Pain in extremityMusculoskeletal and connective tissue disorders1/1024/98
ArthralgiaMusculoskeletal and connective tissue disorders4/1021/98
AnaemiaBlood and lymphatic system disorders0/1023/98
GoutMetabolism and nutrition disorders0/1023/98
HypertensionVascular disorders1/1023/98
Urinary Tract InfectionInfections and infestations3/1020/98
Atrial fibrillationCardiac disorders0/1022/98
Peripheral swellingGeneral disorders0/1022/98

Baseline characteristics

Baseline analysis including all patents randomised minus those removed post-randomisation due to screen failures.

Age, Continuous
Age, Continuous(years)ControlDeviceTotal
Mean67.44 ± 9.4468.17 ± 8.8467.79 ± 9.13
Sex: Female, Male
Sex: Female, Male(Participants)ControlDeviceTotal
Female282250
Male7070140
Race (NIH/OMB)
Race (NIH/OMB)(Participants)ControlDeviceTotal
American Indian or Alaska Native000
Asian336
Native Hawaiian or Other Pacific Islander000
Black or African American314
White9087177
More than one race011
Unknown or Not Reported202
Body Mass Index
Body Mass Index(kg/m^2)ControlDeviceTotal
Mean28.63 ± 6.6628.10 ± 5.1228.37 ± 5.95
Smoking status
Smoking status(participants)ControlDeviceTotal
Current smoker342256
Former smoker5864122
Never6612
Medical history
Medical history(participants)ControlDeviceTotal
Hypertension6365128
Stroke9918
Heart attack171532
High cholesterol6468132
Angina131023
Diabetes262147
Bypass revascularisation12517
Angio revascularisation251439
Medication
Medication(participants)ControlDeviceTotal
Antiplatelets7975154
Lipid modification therapy8180161
Anticoagulant151025
Antihypertensives6566131
Retired
Retired(participants)ControlDeviceTotal
Yes6968137
No292453

2 further baseline measures are reported on the registry.

08

Study locations

11 sites
  • The Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust
    Bournemouth, United Kingdom
  • North Bristol NHS Trust
    Bristol, BS10 5NB, United Kingdom
  • Cambridge University Hospitals NHS Foundation Trust
    Cambridge, CB2 0QQ, United Kingdom
  • Dorset County Hospital NHS Foundation Trust
    Dorchester, United Kingdom
  • Hull and East Yorkshire Hospitals NHS Foundation Trust
    Hull, HU3 2JZ, United Kingdom
  • Imperial College Healthcare NHS Trust
    London, W2 1NY, United Kingdom
  • St George's University Hospitals NHS Foundation Trust
    London, United Kingdom
  • The Newcastle Upon Tyne Hospitals NHS Foundation Trust
    Newcastle, NE7 7DN, United Kingdom
  • Nottingham University Hospitals NHS Trust
    Nottingham, NG7 2RD, United Kingdom
  • University Hospital Southampton NHS Foundation Trust
    Southampton, SO16 6YD, United Kingdom
  • Taunton and Somerset NHS Foundation Trust
    Taunton, TA1 5DA, United Kingdom
09

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Feb 2018 to primary completion in Mar 2021, 37 months.

Results were first posted in Apr 2024, 3 years after primary completion.

Of 73 non-industry interventional studies with no phase under Intermittent Claudication, half reached primary completion within 46 months of starting (the median), counting those still running; a quarter within 17 and three quarters within 77. This study's 37 months is below that.

Counting every sponsor, half of 84 studies reached it within 41 months; a quarter within 17 and three quarters within 77.

How these figures are worked out, and which studies are left out of them.

Registered
Jan 8, 2018
First posted
Feb 26, 2018
StartActual
Feb 16, 2018
Primary completionActual
Mar 31, 2021
CompletionActual
Sep 30, 2021
Results first posted
Apr 10, 2024
Last update
Apr 11, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 11, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03446027
Responsible party
Sponsor
First posted
Feb 26, 2018
Start date
Feb 16, 2018
Primary completion
Mar 31, 2021
Completion
Sep 30, 2021
Results posted
Apr 10, 2024
Last update
Apr 11, 2024

Study contacts

Professor Davies
principal investigator · Chief Investigator

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Apr 2024. You cannot join it, but the record below documents what was studied.

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