Peripheral artery disease affects the function of the legs of claudicating patients in a diffuse manner irrespective of the segment of the arterial tree primarily involved

Authors

Todd Leutzinger, University of Nebraska at OmahaFollow
Panagiotis Koutakis, University of Nebraska at Omaha
Matthew A. Fuglestad
Hafizur Rahman, University of Nebraska at OmahaFollow
Holly DeSpiegelaere, Omaha and Western Iowa Veterans Affairs Medical CenterFollow
Mahdi Hassan, University of Nebraska at Omaha
Molly Schieber, University of Nebraska at OmahaFollow
Jason Johanning, University of Nebraska Medical CenterFollow
Nick Stergiou, University of Nebraska at OmahaFollow
G. Matthew Longo
George P. Casale, University of Nebraska Medical Center
Sara A. Myers, University of Nebraska at OmahaFollow
Iraklis Pipinos, University of Nebraska Medical CenterFollow

Author ORCID Identifier

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

Rahman - https://orcid.org/0000-0003-1739-3544

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

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

Document Type

Article

Publication Date

7-13-2022

Abstract

Different levels of arterial occlusive disease (aortoiliac, femoropopliteal, multi-level disease) can produce claudication symptoms in different leg muscle groups (buttocks, thighs, calves) in patients with peripheral artery disease (PAD). We tested the hypothesis that different locations of occlusive disease uniquely affect the muscles of PAD legs and produce distinctive patterns in the way claudicating patients walk. Ninety-seven PAD patients and 35 healthy controls were recruited. PAD patients were categorized to aortoiliac, femoropopliteal and multi-level disease groups using computerized tomographic angiography. Subjects performed walking trials both pain-free and during claudication pain and joint kinematics, kinetics, and spatiotemporal parameters were calculated to evaluate the net contribution of the calf, thigh and buttock muscles. PAD patients with occlusive disease affecting different segments of the arterial tree (aortoiliac, femoropopliteal, multi-level disease) presented with symptoms affecting different muscle groups of the lower extremity (calves, thighs and buttocks alone or in combination). However, no significant biomechanical differences were found between PAD groups during the pain-free conditions with minimal differences between PAD groups in the claudicating state. All statistical differences in the pain-free condition occurred between healthy controls and one or more PAD groups. A discriminant analysis function was able to adequately predict if a subject was a control with over 70% accuracy, but the function was unable to differentiate between PAD groups. In-depth gait analyses of claudicating PAD patients indicate that different locations of arterial disease produce claudication symptoms that affect different muscle groups across the lower extremity but impact the function of the leg muscles in a diffuse manner generating similar walking impairments.

Comments

This is an Open Access article licensed under CC0.

DOI: https://doi.org/10.1371/journal.pone.0264598

Journal Title

PLOS One

Recommended Citation

Leutzinger, Todd; Koutakis, Panagiotis; Fuglestad, Matthew A.; Rahman, Hafizur; DeSpiegelaere, Holly; Hassan, Mahdi; Schieber, Molly; Johanning, Jason; Stergiou, Nick; Longo, G. Matthew; Casale, George P.; Myers, Sara A.; and Pipinos, Iraklis, "Peripheral artery disease affects the function of the legs of claudicating patients in a diffuse manner irrespective of the segment of the arterial tree primarily involved" (2022). Journal Articles. 347.
https://digitalcommons.unomaha.edu/biomechanicsarticles/347