• Farhad Rezvani, Dirk Heider, Hans-Helmut König, Lutz Herbarth, Patrick Steinisch, Franziska Schuhmann, Hannes Böbinger, Gundula Krack, Thomas Korth, Lara Thomsen, Daniela Patricia Chase, Robert Schreiber, Mark-Dominik Alscher, Benjamin Finger, Martin Härter, and Jörg Dirmaier.
• Department of Medical Psychology, University Medical Center Hamburg-Eppendorf; Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf; KKH Health Insurance Fund, Hanover; TK Technicians' Health Insurance Fund, Hamburg; mhplus Health Insurance Fund, Ludwigsburg; IEM GmbH, Aachen; Philips GmbH Market DACH, Hamburg; Robert Bosch Society for Medical Research, Bosch Health Campus GmbH, Stuttgart.
• Dtsch Arztebl Int. 2024 May 17; 121 (10): 323330323-330.

BackgroundSupervised exercise programs are used to treat intermittent claudication (IC). Home-based exercise programs have been developed to lower barriers to participation. We studied the effects of one such exercise program (TeGeCoach) on self-reported walking ability in patients with IC.MethodsIn a pragmatic multicenter randomized controlled trial (registration number NCT03496948), 1982 patients with symp - tomatic IC insured by one of three German statutory health insurance funds received either telephone health coaching with remote exercise monitoring (TeGeCoach; n = 994) or routine care (n = 988). The primary outcome was the change in Walking Impairment Questionnaire (WIQ) scores after 12 and 24 months in the intention-to-treat population. The secondary outcomes were healthrelated quality of life, symptoms of depression or anxiety, health competence, patient activation, alcohol use, and nicotine depen - dence.ResultsThere was a significant group difference in WIQ score in favor of TeGeCoach (p < 0.0001), amounting to 6.30 points at 12 months (Bonferroni-corrected 95% CI [4.02; 8.59], Cohen's d = 0.26) and 4.55 points at 24 months ([2.20; 6.91], d = 0.19). Some of the secondary outcomes also showed positive results in favor of TeGeCoach at 12 months with small effect sizes (d ≥ 0.20), including physical health-related quality of life and patient activation. The average daily step count was not higher in the TeGeCoach group.ConclusionSignificant improvements regarding symptom burden demonstrate the benefit of a home-based exercise program and thus expand the opportunities for guideline-oriented treatment of IC. Future studies should additionally address the effect of home-based exercise programs on clinical variables by means of, for example, the 6-minute walk test.

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