Ventilatory threshold is related to walking tolerance in patients with intermittent claudication

VASA ◽  
2012 ◽  
Vol 41 (4) ◽  
pp. 275-281 ◽  
Author(s):  
da Rocha Chehuen ◽  
G. Cucato ◽  
P. dos Anjos Souza Barbosa ◽  
A. R. Costa ◽  
M. Ritti-Dias ◽  
...  
Keyword(s):  
Blood Flow ◽  
Oxygen Uptake ◽  
Intermittent Claudication ◽  
Lower Limb ◽  
Ventilatory Threshold ◽  
Reactive Hyperemia ◽  
Ankle Brachial Index ◽  
Metabolic Parameters ◽  
Walking Distance ◽  
The Relationship

Background: This study assessed the relationship between lower limb hemodynamics and metabolic parameters with walking tolerance in patients with intermittent claudication (IC). Patients and methods: Resting ankle-brachial index (ABI), baseline blood flow (BF), BF response to reactive hyperemia (BFRH), oxygen uptake (VO2), initial claudication distance (ICD) and total walking distance (TWD) were measured in 28 IC patients. Pearson and Spearman correlations were calculated. Results: ABI, baseline BF and BF response to RH did not correlate with ICD or TWD. VO2 at first ventilatory threshold and VO2peak were significantly and positively correlated with ICD (r = 0.41 and 0.54, respectively) and TWD (r = 0.65 and 0.71, respectively). Conclusions: VO2peak and VO2 at first ventilatory threshold, but not ABI, baseline BF and BFHR were associated with walking tolerance in IC patients. These results suggest that VO2 at first ventilatory threshold may be useful to evaluate walking tolerance and improvements in IC patients.

scholarly journals Simple assessment of quality of life and lower limb functional capacity during cilostazol treatment – results of the SHort-tERm cIlostazol eFFicacy and quality of life (SHERIFF) study

VASA ◽  
2020 ◽  
Vol 49 (3) ◽  
pp. 235-242 ◽  
Author(s):  
Katalin Farkas ◽  
Endre Kolossváry ◽  
Zoltán Járai
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Intermittent Claudication ◽  
Functional Capacity ◽  
Lower Limb ◽  
Ankle Brachial Index ◽  
Walking Distance ◽  
Treatment Results ◽  
Walking Capacity

Summary: Background: Symptomatic peripheral arterial disease (intermittent claudication) is a major cause of disability and mobility loss in older men and women and thus has a significant negative impact on the patients’ quality of life. Both surgical and endovascular revascularization procedures and noninvasive medical therapies, such as supervised training and drug treatment, can improve walking capacity. Cilostazol is the only drug having a class I (level of evidence A) recommendation for the treatment of intermittent claudication (IC). The aim of this study was to evaluate the effect of three-month cilostazol treatment on the health-related quality of life and on the lower limb functional capacity in patients with IC in the clinical practice. Patients and methods: The study was a multicenter, non-interventional trial, performed in Hungary in 2018. 812 PAD patients (Fontaine II stage, mean age: 67.17 years, male/female: 58.25/41.75 %) were enrolled, who received cilostazol (50 or 100 mg b.i.d.) for 3 months. 802 patients completed the study. Quality of life was evaluated with the EQ-5D-3L questionnaire functional capacity with the WELCH (Walking Estimated-Limitation Calculated by History) questionnaire. Pain-free and maximal walking distance, ankle-brachial index (ABI) were measured at baseline and after 3-month treatment. Results: Upon conclusion of the study, the EQ-5D-3L index improved (baseline: –0.46 ± 0.22, 3rd month: –0.26 ± 0.18; p < 0.0001) and there was a significant increase in the WELCH score as well (19 ± 14, 31 ± 18; respectively, p < 0.0001). Both pain-free and maximal walking distance improved significantly by 54.52 % (median: 53.85 %) and 42.5 % (median: 34.68 %); respectively (p < 0.001). Adverse events occurred in 10 patients, 1 patient stopped cilostazol treatment because of side effects. Conclusions: Three months cilostazol treatment significantly improved quality of life and lower limb functional capacity in patients with intermittent claudication. The WELCH questionnaire is a useful tool for the evaluation of intermittent claudication treatment in the clinical practice.

Maximal vascular leg conductance in trained and untrained men

1987 ◽  
Vol 62 (2) ◽  
pp. 606-610 ◽  
Author(s):  
P. G. Snell ◽  
W. H. Martin ◽  
J. C. Buckey ◽  
C. G. Blomqvist
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Oxygen Uptake ◽  
Maximal Oxygen Uptake ◽  
Reactive Hyperemia ◽  
Venous Occlusion ◽  
Vascular Conductance ◽  
Blood Flows ◽  
Arterial Blood ◽  
Sedentary Subjects

Lower leg blood flow and vascular conductance were studied and related to maximal oxygen uptake in 15 sedentary men (28.5 +/- 1.2 yr, mean +/- SE) and 11 endurance-trained men (30.5 +/- 2.0 yr). Blood flows were obtained at rest and during reactive hyperemia produced by ischemic exercise to fatigue. Vascular conductance was computed from blood flow measured by venous occlusion plethysmography, and mean arterial blood pressure was determined by auscultation of the brachial artery. Resting blood flow and mean arterial pressure were similar in both groups (combined mean, 3.0 ml X min-1 X 100 ml-1 and 88.2 mmHg). After ischemic exercise, blood flows were 29- and 19-fold higher (P less than 0.001) than rest in trained (83.3 +/- 3.8 ml X min-1 X 100 ml-1) and sedentary subjects (61.5 +/- 2.3 ml X min-1 X 100 ml-1), respectively. Blood pressure and heart rate were only slightly elevated in both groups. Maximal vascular conductance was significantly higher (P less than 0.001) in the trained compared with the sedentary subjects. The correlation coefficients for maximal oxygen uptake vs. vascular conductance were 0.81 (trained) and 0.45 (sedentary). These data suggest that physical training increases the capacity for vasodilation in active limbs and also enables the trained individual to utilize a larger fraction of maximal vascular conductance than the sedentary subject.

Indikationen und Limitationen des Gehtrainings bei Patienten mit Cladicatio intermittens

VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Takashi Ohta ◽  
Sugimoto ◽  
Takeuchi ◽  
Hosaka ◽  
Ishibashi
Keyword(s):  
Exercise Training ◽  
Intermittent Claudication ◽  
Recovery Time ◽  
Ankle Brachial Index ◽  
Walking Distance ◽  
Hemodynamic Parameters ◽  
Arterial Reconstruction ◽  
Arteriosclerosis Obliterans ◽  
Degree Of Satisfaction ◽  
Selection Of

Background: The selection of candidates for exercise training among patients with intermittent claudication is still a matter of debate. Patients and methods: Forty-nine patients with intermittent claudication due to arteriosclerosis obliterans were tested. Forty-six patients were men and 3 were women, with an average age of 65 years (range, 46 to 76 years). The patients walked on a treadmill at 2.4 km/h on a 12% upgrade followed by an appropriate period of rest for 30 minutes twice a day during a 3-week hospitalization. Programs were individualized for each patient. Four parameters were assessed after exercise training: (1) Ankle-brachial index (ABI) at rest, (2) Fall in ABI after 40 m of treadmill walking (ABI Fall 40), (3) the recovery time (RT 40) required for the ABI to return to resting levels after 40 m of walking, and (4) the maximal walking distance (MWD) on the treadmill. Results: The average ABI at rest before the 3-week training period was 0.60 ± 0.02 (mean ± SE), and after training it was 0.62 ± 0.02. There was a small although not statistically significant increase in the ABI after training. This increase in the ABI did not exceed 0.21. The average ABI Fall 40 before training was 0.36 ± 0.01, and after training it was 0.30 ± 0.02. The average RT 40 before training was 9.9 ± 0.8 min, and after training it was 6.2 ± 0.6 min. There were significant decreases in the ABI Fall 40 and RT 40 after training (p < 0.01 and p < 0.001, respectively). The MWD increased after training in 48 of the 49 patients. The average MWD increased from 134 ± 13 m to 226 ± 32 m after training (p < 0.001). The occlusion levels did not influence the results as training effects and hemodynamic parameters. Fourteen of 49 patients desired arterial reconstruction after exercise training. Conclusions: Patients with shorter RT 40’s before training achieved greater increases in the MWD after training. In patients with an RT 40 under 12 min, exercise training is indicated. However, there is some discrepancy between the increase in MWD and the degree of satisfaction in individual patients.

The test to retest reproducibility of walking test for intermittent claudication associated with lumbar spinal stenosis

2020 ◽  
Author(s):  
Shinji Tanishima ◽  
Hu Jianzhong ◽  
Zhao Jie ◽  
Yang Huilin ◽  
Hideki Nagashima ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Lower Limb ◽  
Cauda Equina ◽  
Walking Distance ◽  
Walking Test ◽  
Lower Limb Pain ◽  
Significant Difference ◽  
Lumbar Spinal

Abstract Background The walking test is useful to evaluate leg numbness and pain caused by cauda equina symptoms in patients with lumbar spinal stenosis but there are few reports described about reproducibility. The study aim was to evaluate the reproducibility of the walking test for lumbar spinal stenosis Methods Seventy patients with lumbar spinal stenosis who had intermittent claudication symptoms at a multicenter outpatient clinic were examined prospectively. A walking test was performed at 0 and 4 weeks. We investigated walking distance and lower limb pain and numbness in this study. Pain and numbness were evaluated by using the Visual Analog Scale (VAS) immediately after the walking test for the hip and outside, inside, front, and posterior sides of the lower legs. Cohen’s kappa analysis and interphase correlation coefficients (ICCs) were used to evaluate reproducibility. The Swiss Spinal Stenosis Questionnaire (SSS) was used to evaluate stenosis severity. Results The mean SSS was 30.2 ± 5.5 initially and 29.2 ± 5.2 at week 4, with no significant difference in severity ( P = 0.10). The walking distance ICC between baseline and 4 weeks was 0.670. The interobserver reliabilities for lower limb ache and numbness in both legs were acceptable. The average VAS for lower leg pain was 23.2 ± 25.2 mm at baseline and 27.4 ± 28.8 mm at week 4. The ICC was 0.668. The average VAS for leg numbness was 23.4 ± 26.7 mm at baseline and 24.8 ± 25.2 mm at week 4. The ICC was 0.683. Conclusions The walking test walking distance and symptomatic site results were reproducible.

scholarly journals The Relationship between Free-Living Daily Physical Activity and the Severity of Peripheral Arterial Occlusive Disease

1997 ◽  
Vol 2 (4) ◽  
pp. 286-291 ◽  
Author(s):  
Debra J Sieminski ◽  
Andrew W Gardner
Keyword(s):  
Physical Activity ◽  
Intermittent Claudication ◽  
Peripheral Arterial Occlusive Disease ◽  
Ankle Brachial Index ◽  
Arterial Occlusive Disease ◽  
Daily Physical Activity ◽  
Occlusive Disease ◽  
Free Living ◽  
Peripheral Arterial ◽  
The Relationship

The purposes of this study were to assess the magnitude of the reduction in free-living daily physical activity of claudicants compared with age-matched controls, and to examine the relationship between the severity of peripheral arterial occlusive disease (PAOD) and free-living daily physical activity. Eighty-five PAOD patients with intermittent claudication and 59 non-PAOD subjects with a resting ankle/brachial index (ABI) of 0.63 ± 0.20 and 1.21 ± 0.08, respectively, were monitored for 2 consecutive weekdays with an accelerometer and pedometer worn on each hip. The times to onset and to maximal claudication pain were also measured in the claudicants during a graded treadmill test to assess the functional limitations imposed by PAOD. The PAOD group had a 42% lower energy expenditure as measured from the accelerometer (357 ± 238 kcal/day versus 616 ± 363 kcal/day; p < 0.001) and a 45% lower pedometer reading (4737 ± 2712 steps/day versus 8672 ± 4235 steps/day; p < 0.001) than the non-PAOD group. Furthermore, the relationship between free-living daily physical activity and ABI in PAOD patients was significant for both the accelerometer ( r = 0.41; p < 0.001) and the pedometer ( r = 0.41; p < 0.001). The rate of decline in free-living daily activity was 42 kcal/day and 612 steps/day per 0.10 drop in ABI. The correlation between free-living daily physical activity and time to maximal claudication pain (6:25 ± 3:30 min:s) in the PAOD group was significant for both the accelerometer ( r = 0.30; p = 0.05) and the pedometer ( r = 0.36; p = 0.03). However, the time to onset of claudication pain (3:02 ± 2:22 min:s) in the PAOD group was not related to either the accelerometer ( r = −0.02; p = 0.86) or the pedometer ( r = 0.18; p = 0.28) activity values. In conclusion, free-living daily physical activity was 42% to 45% lower in PAOD patients with intermittent claudication than in apparently healthy subjects of similar age. Moreover, claudicants were progressively more sedentary with an increase in PAOD severity.

scholarly journals Influence of the Physical Training on Muscle Function and Walking Distance in Symptomatic Peripheral Arterial Disease in Elderly

2018 ◽  
Vol 2018 ◽  
pp. 1-16 ◽  
Author(s):  
Katarzyna Kropielnicka ◽  
Wioletta Dziubek ◽  
Katarzyna Bulińska ◽  
Małgorzata Stefańska ◽  
Joanna Wojcieszczyk-Latos ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Physical Training ◽  
Lower Limb ◽  
Training Group ◽  
Walking Distance ◽  
Nordic Walking ◽  
Group Iii ◽  
Exercise Rehabilitation ◽  
Force Velocity ◽  
Group Ii

Introduction. A typical symptom of chronic lower-limb ischaemia is lower-limb pain, which occurs during walking forcing the patient to stop, intermittent claudication (IC). Exercise rehabilitation is the basic form of treatment for these patients. Aim. The aim of this study was to compare the effectiveness of three types of physical training programmes conducted over a 12-week period in patients with chronic lower-limb arterial insufficiency. Materials and Methods. Ninety-five people qualified for the 3-month supervised motor rehabilitation programme, conducted three times a week. The respondents were assigned to three types of rehabilitation programmes using a pseudo-randomization method: Group I (TW), subjects undertaking treadmill walking training; Group II (NW), subjects undertaking Nordic walking training; Group III (RES+NW), subjects undertaking resistance and Nordic walking training. Treadmill test, 6 Minute Walk Test (6MWT), and isokinetic test were repeated after 3 months of rehabilitation, which 80 people completed. Results. Combined training (RES+NW) is more effective than Nordic walking alone and supervised treadmill training alone for improving ankle force-velocity parameters (p<0.05) in patients with intermittent claudication. Each of the proposed exercise rehabilitation programmes increased walking distance of patients with intermittent claudication (p<0.05), especially in 6MWT (p=0.001). Significant relationships of force-velocity parameters are observed in the maximum distance obtained in 6MWT, both in Group III (RES + NW) and in Group II (NW) at the level of moderate and strong correlation strength, which indicates that if the lower limbs are stronger the walking distance achieved in 6MWT is longer. Conclusions. Given both the force-velocity parameters and the covered distance, the training RES + NW gives the most beneficial changes compared to training TW alone and NW alone. All types of training increased walking distance, which is an important aspect of the everyday functioning of people with IC.

scholarly journals The evaluation of surgical reconstruction for intermittent claudication by the Walking Impairment Questionnaire

2010 ◽  
Vol 9 (4) ◽  
pp. 215-219
Author(s):  
Masaya Nakashima ◽  
Kazuo Yamaguchi
Keyword(s):  
Blood Flow ◽  
Intermittent Claudication ◽  
Walking Speed ◽  
Stair Climbing ◽  
Arterial Blood Flow ◽  
Walking Distance ◽  
Surgical Reconstruction ◽  
Arterial Blood ◽  
Rate Of Increase

BACKGROUND: No standards reflecting the quality of life (QOL) and activity of daily living (ADL) in postoperative clinical course have been validated in the area of vascular disease. The Walking Impairment Questionnaire (WIQ) is a disease-specific questionnaire that evaluates patients with intermittent claudication due to arteriosclerosis obliterans (ASO). The WIQ uses four subscales: pain severity, walking distance, walking speed, and stair climbing while walking. OBJECTIVE: To evaluate the correlation between postoperative arterial blood flow and the Japanese edition of the WIQ. METHODS: Thirty-one patients (47 limbs) with intermittent claudication who had been subjected to lower limb surgical arterial reconstruction were assessed by WIQ, and compared with Ankle-Brachial Pressure Index (ABPI) and angiography. RESULTS: A significant increase in the WIQ score was identified in walking pain (26 versus 89.5, p<0.001), walking distance (13.1 versus 83.3, p<0.001), walking speed (10 versus 46, p<0.001), and stair climbing (6.2 versus 79, p<0.001). The correlation coefficient between the increase in postoperative ABPI and the WIQ score was R²=0.1889, which shows weak correlation. The correlation between blood flow obstruction due to the postoperative bypass that was scored by angiography and WIQ score was R²=0.3894, which shows moderate correlation. CONCLUSION: An improvement in the Japanese edition of the WIQ score was correlated not only with the patients' QOL after bypass revascularization but also with the rate of increase of postoperative ABPI and image findings, such as the postoperative angiography.

Sign in / Sign up

Export Citation Format

Share Document