Muscle strength and control characteristics are altered by peripheral artery disease

Authors

Molly Schieber, University of Nebraska at OmahaFollow
Ryan Hasenkamp, University of Nebraska at OmahaFollow
Iraklis Pipinos, Department of Surgery, Veterans Affairs Medical Center and University of Nebraska Medical Center, Omaha, NE USAFollow
Jason Johanning, University of Nebraska Medical CenterFollow
Nicholas Stergiou, University of Nebraska at OmahaFollow
Holly DeSpiegelaere, Omaha and Western Iowa Veterans Affairs Medical CenterFollow
Jung Chien, University of Nebraska at OmahaFollow
Sara A. Myers, University of Nebraska at OmahaFollow

Author ORCID Identifier

Myers - https://orcid.org/0000-0002-2934-2624

Stergiou - https://orcid.org/0000-0002-9737-9939

Pipinos - https://orcid.org/0000-0001-6873-6346

Document Type

Article

Publication Date

7-1-2017

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.

Comments

This is an Accepted Manuscript of an article published by Elsevier in Journal of Vascular Surgery on July 1, 2017 available online: https://doi.org/10.1016/j.jvs.2017.01.051

Journal Title

Journal of Vascular Surgery

Volume

66

Issue

1

First Page

178

Last Page

186

Recommended Citation

Schieber, MN, Hasenkamp, RM, Pipinos, II, Johanning, JM, Stergiou, N, DeSpiegelaere, HK, Chien, JH, Myers, SA. Muscle strength and control characteristics are altered by peripheral artery disease. Journal of Vascular Surgery. 2017 Jul;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.