Document Type
Article
Publication Date
12-8-2023
Abstract
Peripheral artery disease (PAD) is characterized by reduced blood flow to the extremities due to atherosclerosis. Studies report impaired gait mechanics in patients with lower extremity PAD. We hypothesized that revascularization surgery would improve gait mechanics when quantified by net lower limb joint work across the stance phase of walking. We performed gait analyses in 35 patients with PAD and 35 healthy, older adults. Patients with PAD performed a walking protocol prior to and six months following revascularization surgery. Healthy adults only took part in a single walking session. Lower limb joint powers were calculated using inverse dynamics and were integrated across early, middle, and late stance phases to determine the work performed during each phase (J kg−1). The work mechanical ratio between positive-producing and negative-producing phases of stance was calculated for each lower-limb joint. Self-selected walking speed significantly increased from 1.13 ± 0.2 ms−1 to 1.26 ± 0.18 ms−1 in patients following revascularization (p < 0.001). We observed a significant decrease in positive late stance work (p < 0.001) in conjunction with more negative work during early stance (p < 0.001) in patients following revascularization. Revascularization surgery led to faster walking without an increase in the ankle joint’s mechanical ratio. Our results suggest faster walking was achieved via work done at the hip rather than the ankle. These findings suggest that additional therapies that facilitate the restoration of muscle, tissue, and nervous system damage caused by years of having reduced blood flow to the limbs might still be beneficial following revascularization.
DOI
https://doi.org/10.1016/j.jbiomech.2023.111880
Journal Title
Journal of Biomechanics
Volume
162
Recommended Citation
Dzewaltowski, Alex; Pipinos, Iraklis; Schieber, Molly; Johanning, Jason; Casale, George P.; Myers, Sara A.; and Malcolm, Philippe, "Lower limb revascularization leads to faster walking but with less efficient mechanics in claudicating patients" (2023). Journal Articles. 376.
https://digitalcommons.unomaha.edu/biomechanicsarticles/376
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
This article was published open access using the open access publishing agreement between the University of Nebraska and Elsevier.