TY - JOUR
T1 - Peripheral artery disease causes consistent gait irregularities regardless of the location of leg claudication pain
AU - Rahman, Hafizur
AU - Leutzinger, Todd
AU - Hassan, Mahdi
AU - Schieber, Molly
AU - Koutakis, Panagiotis
AU - Fuglestad, Matthew A.
AU - DeSpiegelaere, Holly
AU - Longo, G. Matthew
AU - Malcolm, Philippe
AU - Johanning, Jason M.
AU - Casale, George P.
AU - Pipinos, Iraklis I.
AU - Myers, Sara A.
N1 - Publisher Copyright:
© 2023 The Author(s)
PY - 2024/4
Y1 - 2024/4
N2 - Background: The most common symptom of peripheral artery disease (PAD) is intermittent claudication that involves the calf, thigh, and/or buttock muscles. How the specific location of this leg pain is related to altered gait, however, is unknown. Objectives: We hypothesized that because the location of claudication symptoms uniquely affects different leg muscle groups in people with PAD, this would produce distinctive walking patterns. Methods: A total of 105 participants with PAD and 35 age-matched older volunteers without PAD (CTRL) were recruited. Participants completed walking impairment questionnaires (WIQ), Gardner-Skinner progressive treadmill tests, the six-minute walk test, and we performed an advanced evaluation of the biomechanics of their overground walking. Participants with PAD were categorized into 4 groups according to their stated pain location(s): calf only (C, n = 43); thigh and calf (TC, n = 18); buttock and calf (BC, n = 15); or buttock, thigh, and calf (BTC, n = 29). Outcomes were compared between CTRL, C, TC, BC and BTC groups using a one-way ANOVA with post-hoc comparisons to identify and assess statistically significant differences. Results: There were no significant differences between CTRL, C, TC, BC and BTC groups in distances walked or walking speed when either pain-free or experiencing claudication pain. Each participant with PAD had significantly dysfunctional biomechanical gait parameters, even when pain-free, when compared to CTRL (pain-free) walking data. During pain-free walking, out of the 18 gait parameters evaluated, we only identified significant differences in hip power generation during push-off (in C and TC groups) and in knee power absorption during weight acceptance (in TC and BC groups). There were no between-group differences in gait parameters while people with PAD were walking with claudication pain. Conclusions: Our data demonstrate that PAD affects the ischemic lower extremities in a diffuse manner irrespective of the location of claudication symptoms. Database Registration: ClinicalTrials.gov NCT01970332.
AB - Background: The most common symptom of peripheral artery disease (PAD) is intermittent claudication that involves the calf, thigh, and/or buttock muscles. How the specific location of this leg pain is related to altered gait, however, is unknown. Objectives: We hypothesized that because the location of claudication symptoms uniquely affects different leg muscle groups in people with PAD, this would produce distinctive walking patterns. Methods: A total of 105 participants with PAD and 35 age-matched older volunteers without PAD (CTRL) were recruited. Participants completed walking impairment questionnaires (WIQ), Gardner-Skinner progressive treadmill tests, the six-minute walk test, and we performed an advanced evaluation of the biomechanics of their overground walking. Participants with PAD were categorized into 4 groups according to their stated pain location(s): calf only (C, n = 43); thigh and calf (TC, n = 18); buttock and calf (BC, n = 15); or buttock, thigh, and calf (BTC, n = 29). Outcomes were compared between CTRL, C, TC, BC and BTC groups using a one-way ANOVA with post-hoc comparisons to identify and assess statistically significant differences. Results: There were no significant differences between CTRL, C, TC, BC and BTC groups in distances walked or walking speed when either pain-free or experiencing claudication pain. Each participant with PAD had significantly dysfunctional biomechanical gait parameters, even when pain-free, when compared to CTRL (pain-free) walking data. During pain-free walking, out of the 18 gait parameters evaluated, we only identified significant differences in hip power generation during push-off (in C and TC groups) and in knee power absorption during weight acceptance (in TC and BC groups). There were no between-group differences in gait parameters while people with PAD were walking with claudication pain. Conclusions: Our data demonstrate that PAD affects the ischemic lower extremities in a diffuse manner irrespective of the location of claudication symptoms. Database Registration: ClinicalTrials.gov NCT01970332.
KW - Claudication
KW - Gait biomechanics
KW - Location of claudication pain
KW - Peripheral artery disease
UR - http://www.scopus.com/inward/record.url?scp=85180587210&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85180587210&partnerID=8YFLogxK
U2 - 10.1016/j.rehab.2023.101793
DO - 10.1016/j.rehab.2023.101793
M3 - Article
C2 - 38118246
AN - SCOPUS:85180587210
SN - 1877-0657
VL - 67
JO - Annals of Physical and Rehabilitation Medicine
JF - Annals of Physical and Rehabilitation Medicine
IS - 3
M1 - 101793
ER -