Gait alterations associated with walking impairment in people with peripheral arterial disease with and without intermittent claudication

被引:70
作者
McDermott, MM
Ohlmiller, SM
Liu, K
Guralnik, JM
Martin, GJ
Pearce, WH
Greenland, P
机构
[1] Northwestern Univ, Sch Med, Dept Surg, Div Vasc Surg, Chicago, IL 60611 USA
[2] NIA, Epidemiol Demog & Biometry Program, Bethesda, MD 20892 USA
[3] Northwestern Univ, Sch Med, Dept Prevent Med, Chicago, IL USA
[4] Northwestern Univ, Sch Med, Dept Med, Chicago, IL 60611 USA
关键词
peripheral arterial disease; physical activity; intermittent claudication; physical functioning;
D O I
10.1046/j.1532-5415.2001.49151.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
OBJECTIVES: To describe gait alterations associated with impaired walking endurance in patients with and without lower-extremity peripheral arterial disease (PAD) and determine whether the Caltrac accelerometer provides a valid measure of physical activity in PAD. DESIGN: Cross-sectional. SETTING: Academic medical center. PARTICIPANTS: PAD (n = 40) and non-PAD patients (n = 22) from two Chicago hospitals. MEASUREMENTS: Participants underwent measurement of the ankle brachial index (ABI), leg length, and 6-minure walk. Steps per minute and step length were measured during the first and last 100 feet of the 6-minute walk. Participants wore a Caltrac accelerometer, sensitive to vertical acceleration, during the 6-minute walk and for 7 continuous days. RESULTS: Five PAD participants (13%) and one non-PAD participant (5%) ceased walking before the end of 6 minutes. Among the remaining participants, distance walked in 6 minutes was more highly related to walking velocity during the last 100 feet of the walk than walking velocity during the first 100 feet. ABI was associated significantly with cadence (20.77 steps/minute per unit ASI, P < .001) but not step length (10.12 centimeters/unit ABI, P < .08). ABI was associated significantly with 6-minute walk distance (493 feet/unit ABI, P = .018), but this association disappeared completely after adjustment for step length and cadence. We found no difference in accelerometer scores between PAD and non-PAD participants over a fixed distance of 800 feet (7.34 vs 7.17 activity units, P = .789). However, scores were significantly different after 7 days (730.8 vs 1,485.0 activity units, P = .003). CONCLUSION: Walking performance in PAD patients who completed 6 minutes of walking was largely determined by a decline in walking velocity rather than slower initial walking velocity. ABI was more closely associated with cadence than step length. Future studies should assess the effect of exercise programs and revascularization on cadence and step length in PAD.
引用
收藏
页码:747 / 754
页数:8
相关论文
共 20 条
[1]  
Criqui M H, 1996, Vasc Med, V1, P65
[2]  
FARINON AM, 1984, CLIN NEUROPATHOL, V3, P240
[3]   Relationship between free-living daily physical activity and ambulatory measures in older claudicants [J].
Gardner, AW ;
Womack, CJ ;
Sieminski, DJ ;
Montgomery, PS ;
Killewich, LA ;
Fonong, T .
ANGIOLOGY, 1998, 49 (05) :327-337
[4]  
GUYATT GH, 1985, CAN MED ASSOC J, V132, P919
[5]  
Hedberg B, 1989, Eur J Vasc Surg, V3, P315, DOI 10.1016/S0950-821X(89)80067-2
[6]   EFFECT OF DIAGNOSTIC-CRITERIA ON THE PREVALENCE OF PERIPHERAL ARTERIAL-DISEASE - THE SAN-LUIS VALLEY DIABETES STUDY [J].
HIATT, WR ;
HOAG, S ;
HAMMAN, RF .
CIRCULATION, 1995, 91 (05) :1472-1479
[7]   Use of ankle brachial pressure index to predict cardiovascular events and death: A cohort study [J].
Leng, GC ;
Fowkes, FGR ;
Lee, AJ ;
Dunbar, J ;
Housley, E ;
Ruckley, CV .
BMJ-BRITISH MEDICAL JOURNAL, 1996, 313 (7070) :1440-1444
[8]   The effects of peripheral vascular disease on gait [J].
McCully, K ;
Leiper, C ;
Sanders, T ;
Griffin, E .
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 1999, 54 (07) :B291-B294
[9]   The ankle brachial index independently predicts walking velocity and walking endurance in peripheral arterial disease [J].
McDermott, MM ;
Liu, K ;
Guralnik, JM ;
Mehta, S ;
Criqui, MH ;
Martin, GJ ;
Greenland, P .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1998, 46 (11) :1355-1362
[10]   Lower ankle/brachial index, as calculated by averaging the dorsalis pedis and posterior tibial arterial pressures, and association with leg functioning in peripheral arterial disease [J].
McDermott, MM ;
Criqui, MH ;
Liu, K ;
Guralnik, JM ;
Greenland, P ;
Martin, GJ ;
Pearce, W .
JOURNAL OF VASCULAR SURGERY, 2000, 32 (06) :1164-1171