A comparative study of treadmill tests and heel raising exercise for peripheral arterial disease

Objectives: This two part study validated a 1 min treadmill exercise test and compared this with simple heel raising exercise. Methods: In an initial study of 24 claudicants (aged 43-79, median 63 years), ankle pressures were measured immediately after repeated treadmill exercises: for 1 min, until onset of claudication, and until maximum tolerated walking distance. Absolute value, fall and percent change in pressures were calculated. The results of this part of the study were then used as a ''gold standard'' for comparison with 30 s of heel raising and treadmill exercise. This second stage was performed on 21 symptomatic limbs (14 claudicants aged 42-73, median 69 years). Results: Variability was least for pressures expressed as percent change after 1 min of exercise. The paired t-test revealed a significant correlation between the two methods of exercise (p<0.05). Conclusion: Heel raising produced changes in ankle pressure which correlated well with those induced by treadmill exercise. We recommend the use of simple heel raising when a stress test is required to diagnose lower limb arterial insufficiency in the outpatient clinic.