Journal of Social, Behavioral, and Health Sciences




We examined the association between health expectations, baseline physical activity, and self-reported symptom severity among patients with claudication: calf pain that occurs during walking and is relieved at rest. Beliefs and attitudes toward exercise influence the behavior. When walking is prescribed as an alternative to surgical intervention with the intention of decreasing symptom severity, as is the case with claudication, it is important to assess patient perceptions, beliefs, and expectations. Through a phone survey, participants described the severity of their symptoms via the Walking Impairment Questionnaire. Data were collected on (1) health expectations and attitudes, assessments of value placed on recovery in the form of associated risks and benefits, and (2) daily physical activity (Physical Activity Scale for the Elderly, known as the PASE). Between February and August 2016, twenty participants were enrolled. The median age among the predominantly male cohort (19, 95%) was 69 years (interquartile range: 66–75 years). Most participants were “risk-seeking” in that 75% (12/16) were willing to accept the risk of amputation associated with surgery regardless of the level of symptom improvement. The alternative was walking, which is associated with no risk of amputation. Individuals who expected greater walking benefit reported walking greater distances with less difficulty (p = .04; unadjusted). Given that most participants were willing to accept some risk of amputation despite the equivalent effectiveness of exercise and surgery in treating claudication, understanding a patient’s perspective is critical to identifying the appropriate approach that will treat symptoms with the least adverse effects.