Document Type

Article

Publication Date

4-2009

Abstract

Objective

Claudication is the most common presentation of peripheral arterial disease (PAD), producing significant ambulatory compromise. Claudicating patients, most of whom are elderly, have reduced mobility and poor health outcomes, including an increased risk of falls. The gait of elderly fallers is characterized by increased variability. Increase in the variability of the locomotor system makes the gait more noisy and unstable. The purpose of this study is to investigate gait variability in patients with PAD.

Methods

Nineteen symptomatic PAD patients (age, 63.6 ± 9.8 years; body mass, 82.1 ± 18.5 kg; height, 1.71 ± 0.06 m) walked on a treadmill in the absence of pain or claudication symptoms while joint flexion and extension kinematics were captured. Results were compared with results obtained from 17 matched healthy controls (age, 65.2 ± 12.5 years; body mass, 82.0 ± 25.9.5 kg; height, 1.73 ± 0.08 m). Relative joint angles were calculated for the ankle, knee, and hip flexion/extension, and the stride-to-stride variability of joint flexion and extension was calculated from at least 30 consecutive footfalls. Variability was expressed using the largest Lyapunov exponent, standard deviation, and coefficient of variation. Independent t tests were used to compare gait variability between groups.

Results

Symptomatic PAD patients had significantly higher largest Lyapunov exponent values and coefficient of variation values for all joints, and higher standard deviation values at the ankle and the hip (P < .05).

Conclusion

Symptomatic PAD patients have increased gait variability at the ankle, knee, and hip joints at baseline ambulation in the absence of claudication pain. Our findings indicate significant baseline deterioration in the locomotor system of symptomatic PAD patients. This deterioration results in increased noise and instability of gait and is a potential contributing factor to the falls and mobility problems experienced by symptomatic PAD patients.

Comments

NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Vascular Surgery. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Vascular Surgery, [Vol. 49, Issue 4 (2009)] http://dx.doi.org/10.1016/j.jvs.2008.11.020.

Journal Title

Journal of Vascular Surgery

Volume

49

Issue

4

First Page

64

Last Page

70

FinalAppendix.pdf (95 kB)
Appendix

Figure1.pdf (41 kB)
Figure 1

Figure2.pdf (205 kB)
Figure 2

Final_Figure Legends.pdf (69 kB)
Figure Legends

Table 1.pdf (11 kB)
Table 1

Table 2.pdf (6 kB)
Table 2

Table 3.pdf (6 kB)
Table 3

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