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MOSAIC Trial logoMotivating Structured Walking Activity in People with Intermittent Claudication (MOSAIC) 

Welcome to the website for the MOSAIC trial.

The MOSAIC trial evaluates a new physiotherapy treatment for people with Intermittent Claudication. The trial is now open and will include 192 people aged 50 years and over with Intermittent Claudication from four NHS trusts in London and South-East England.

This site is designed for patients, clinicians and researchers who are interested to find out more about the MOSAIC Trial. 

If you have any questions or comments, please get in touch with the MOSAIC team using the contact details at the bottom of this page.


What is Intermittent Claudication?

Intermittent Claudication is leg discomfort or pain caused by poor blood circulation to the lower limbs. It is a common symptom of peripheral arterial disease, a condition involving narrowed or blocked leg arteries, which affects about 20% of older adults. People with Intermittent Claudication who took part in a previous study describe their symptoms in various ways.

Word map
Responses to the question 'What is Intermittent Claudication like?' by 15 people with Intermittent Claudication during focus groups (Galea et al., 2008) 


Why is this research important?

Walking exercise is recommended for people with Intermittent Claudication as an effective way to improve their symptoms and walking capacity, but participation is low. Starting and maintaining new healthy behaviours, such as walking, may require extra support but there is little research investigating how to help people with Intermittent Claudication change their behaviour and complete sufficient walking.

Working with patients and healthcare professionals, we developed a brief physiotherapist-led treatment to support people with Intermittent Claudication increase their walking that was feasible to deliver and test.

MOSAIC treatment is designed to help people understand Intermittent Claudication and the effect walking has on their condition and to support them in planning and carrying out walking exercise. The aim of this trial is to compare the effect our treatment has on walking with the usual NHS treatment.

We completed a small preliminary study to test the feasibility of delivering MOSAIC and here are some quotes from participants who enrolled on this earlier study (Galea Holmes, Weinman, Bearne, 2015).

quotes from participants who enrolled in an earlier study

Information for patient and participants

Who can take part?

We welcome people who are aged at least 50 years, who have been diagnosed with Intermittent Claudication and are under the care of the vascular surgery teams at Guy’s and St Thomas’ Hospital, King’s College Hospital, Ashford and St Peter’s Hospital, St George’s University Hospital NHS Foundation Trust, the Royal Free and Royal London Hospitals.  

What is involved?

The study involves two hospital visits for assessments (including questionnaires and a walking task) before and after either completing the MOSIAC or continuing with your usual care and then completing a third questionnaire assessment at home. Whether you complete MOSAIC or not will be allocated by chance by a computer.

The diagram below illustrates the pathway that participants will take after being enrolled in the study.

diagram illustrates the pathway that participants will take after being enrolled in the study

If you would like to have more information about this trial

Please read more details in the Participant Information Sheet (DOC, 70KB)

Other sources of information for patients with Intermittent Claudication

Information for clinicians and researchers

MOSAIC is a physiotherapist-led treatment and the trial team work closely with the physiotherapists delivering MOSAIC.

As specialists in exercise rehabilitation and prescription, physiotherapists are well equipped to support self-management and change exercise and physical activity behaviour, such as walking for IC. Physiotherapists’ scope of practice includes an understanding of psychosocial factors that influence health behaviour and responses to physiotherapy treatment.

Building on physiotherapists existing skills and experience, we provide bespoke training about how to deliver MOSAIC and meet with the MOSAIC physiotherapists regularly to support them.

Mosaic Treatment

Process map of mosaic trial treament

Conferences and dissemination

We will be presenting information about the trial processes and findings to clinicians, researchers and patients regularly throughout the trial.


Ethical approval has been obtained from London – Bloomsbury Research Ethics Committee

REC reference: 17/LO/0568

Trial sponsors and registration


Directorate of Research Management & Innovation
King's College London
Room 1.14 Hodgkin Building
Guy's Campus
London SE1 1UL

Research & Development Department
Guy’s & St Thomas’ NHS Foundation Trust
Tower Wing, Great Maze Pond

Trial registration number
ISRCTN 14501418

MOSAIC Trial team

  • Dr Lindsay Bearne | Chief Investigator | School of Population Health & Environmental Sciences, King’s College London
  • Dr Julie Bieles | Research Associate | School of Population Health & Environmental Sciences, King’s College London
  • Mr Graham Fisher | Patient Advisor
  • Dr Brittannia Volkmer | Research Assistant | School of Population Health & Environmental Sciences, King’s College London
  • Professor Janet Peacock | Senior Trial Statistician | School of Population Health & Environmental Sciences, King’s College London
  • Ms Saskia Eddy | Trial Statistician | School of Population Health & Environmental Sciences, King’s College London
  • Mr Bijan Modarai | Consultant Vascular Surgeon | Department of Vascular Surgery, St Thomas’s Hospital
  • Mr Sanjay Patel | Principal Investigator & Consultant Vascular Surgeon| Department of Vascular Surgery, Guy's and St Thomas' NHS Foundation Trust
  • Professor Catherine Sackley | Senior Trialist | School of Population Health and Environmental Sciences, King’s College London
  • Professor John Weinman | Senior Trialist | School of Cancer and Pharmaceutical Sciences 


Dr Lindsay Bearne

Chief Investigator, MOSAIC Trial

Department of Population Health Sciences

King’s College London


Twitter: @LindsayBearne


Funder: This work was supported by The Dunhill Medical Trust [grant number: [R477/0516] 

Dunhill Medical Trust logo


Galea Holmes, M., Weinman, J. A., & Bearne, L. M. (2015). Feasibility of a home-based walking programme for intermittent claudication. In Vascular Societies of Great Britain and Ireland Annual Meeting Conference Proceedings, 11-13 November 2015, Bournemouth, UK.

Galea M, Weinman J, White C, et al. (2013) Do behaviour-change techniques contribute to the effectiveness of exercise therapy in patients with intermittent claudication? A systematic review. Eur J Vasc Endovasc Surg 46(1): 132-141.

Galea MN, Weinman JA and Bearne, LM (2013) “You can’t walk with cramp!”: A qualitative exploration of individuals’ beliefs and experiences of walking as treatment for intermittent claudication. Journal of Health Psychology DOI:

Galea MN, Bray SR and Martin Ginis KA. (2008) Barriers and facilitators for walking in individuals with intermittent claudication. J Aging Phys Act 16(1): 69-84.


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