Author ORCID Identifier
Stergiou - https://orcid.org/0000-0002-9737-9939
Document Type
Article
Publication Date
6-21-2017
Abstract
Objective
Peripheral artery disease (PAD), a common manifestation of atherosclerosis, is characterized by lower leg ischemia and myopathy in association with leg dysfunction. Patients with PAD have impaired gait from the first step they take with consistent defects in the movement around the ankle joint, especially in plantar flexion. Our goal was to develop muscle strength profiles to better understand the problems in motor control responsible for the walking impairment in patients with PAD.
Methods
Ninety-four claudicating PAD patients performed maximal isometric plantar flexion contractions lasting 10 seconds in two conditions: pain free (patient is well rested and has no claudication symptoms) and pain induced (patient has walked and has claudication symptoms). Sixteen matched healthy controls performed the pain-free condition only. Torque curves were analyzed for dependent variables of muscle strength and motor control. Independent t-tests were used to compare variables between groups, and dependent t-tests determined differences between conditions.
Results
Patients with PAD had significantly reduced peak torque and area under the curve compared with controls. Measures of control differed between PAD conditions only. Load rate and linear region duration were greater in the pain condition. Time to peak torque was shorter in the pain condition.
Conclusions
This study conclusively demonstrates that the plantar flexor muscles of the PAD patient at baseline and without pain are weaker in patients with PAD compared with controls. With the onset of claudication pain, patients with PAD exhibit altered muscle control strategies and further strength deficits are manifest compared to baseline levels. The myopathy of PAD legs appears to have a central role in the functional deterioration of the calf muscles, as it is evident both before and after onset of ischemic pain.
Journal Title
Journal of Vascular Surgery
Volume
66
Issue
1
First Page
178
Last Page
186
Recommended Citation
Schieber, M.N., Hasenkamp, R.M., Pipinos, I.I., Johanning, J.M., Stergiou, N., DeSpiegelaere, H.K., Chien, J.H., & Myers, S.A. (2017, June 21). Muscle strength and control characteristics are altered by peripheral artery disease. Journal of Vascular Surgery, 66(1), 178-186. https://doi.org/10.1016/j.jvs.2017.01.051
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Comments
This is an Accepted Manuscript of an article published by Elsevier in Journal of Vascular Surgery on June 21, 2017, available online: https://doi.org/10.1016/j.jvs.2017.01.051