scholarly journals Location of ischemia and ischemic pain intensity affect spatiotemporal parameters and leg muscles activity during walking in patients with intermittent claudication

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Céline Guilleron ◽  
Pierre Abraham ◽  
Bruno Beaune ◽  
Camille Pouliquen ◽  
Samir Henni ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Reaction Force ◽  
Step Length ◽  
Arterial Disease ◽  
Electromyographic Activity ◽  
Ischemic Pain ◽  
Vertical Ground Reaction Force ◽  
Maximum Pain ◽  
Spatiotemporal Parameters ◽  
Peripheral Arterial

AbstractThe ways in which locations of ischemia and ischemic pain affect spatiotemporal gait parameters and leg electromyographic activity during walking have never been investigated in patients with peripheral arterial disease presenting intermittent claudication. Two groups were classified according to unilateral location of ischemia (distal, n = 10, or proximo-distal, n = 12). Patients described pain and three gait phases—initial pain-free, onset of pain and maximum pain—were analyzed. Patients with proximo-distal ischemia walked less (230 ± 111 m vs 384 ± 220 m), with increased step length, step time (+ 5.4% and + 5.8%) and reduced cadence (− 8.2%), than patients with distal ischemia. In both, the peaks of vertical ground reaction force were reduced in maximum pain (Peak1-distal: − 11.4%, Peak1-proximo-distal: − 10.3%; Peak2-distal: − 11.8%, Peak2-proximo-distal: − 9.0%). In the proximo-distal group, tibialis anterior activation peak and time were lower than in the distal group (− 4.5% and − 19.7%). During the maximum pain phase, this peak decreased only in the proximo-distal group (− 13.0%), and gastrocnemius medialis activation peak and time decreased in both groups (− 2.5% in distal and − 4.5% in proximo-distal). Thus, proximo-distal ischemia leads to more adverse consequences in gait than distal ischemia only. Increasing ischemic pain until maximum, but not onset of pain, induced gait adaptations.

scholarly journals Circulating Anti-Beta2-Glycoprotein I Antibodies Are Associated with Endothelial Dysfunction, Inflammation, and High Nitrite Plasma Levels in Patients with Intermittent Claudication

2013 ◽  
Vol 2013 ◽  
pp. 1-8
Author(s):  
Cesar Varela ◽  
Joaquin de Haro ◽  
Silvia Bleda ◽  
Leticia Esparza ◽  
Ignacio Lopez de Maturana ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Intermittent Claudication ◽  
Plasma Levels ◽  
Arterial Disease ◽  
Control Group ◽  
Translational Study ◽  
Reactive Protein ◽  
Glycoprotein I ◽  
Inflammatory Status ◽  
Peripheral Arterial

Our aim is to investigate a possible association of circulating anti-beta2-glycoprotein I antibodies (ABGPI) with the endothelial dysfunction, nitric oxide bioactivity dysregulation, and the inflammatory status that surrounds peripheral arterial disease. We carried out an observational translational study, including 50 male patients with intermittent claudication and a healthy control group of 10 male subjects, age and sex matched with the cases. Flow-mediated arterial dilatation (FMAD) was assessed as a surrogate of endothelial dysfunction, and C-reactive protein (hsCRP) was determined as a marker of inflammation. Nitrite plasma levels were measured by colorimetric analysis. Circulating ABGPI titer was detected with indirect immunofluorescence. Titers <1 : 10 represented the reference range and the lower detection limit of the test. Circulating ABGPI titer ≥1 : 10 was detected in 21 (42%) patients and in none of the control subjects (P<0.01). Patients with ABGPI titer ≥1 : 10 had a lower FMAD (P=0.01). The CRP levels were higher in patients with ABGPI titer ≥1 : 10 (P=0.04). The nitrite plasma levels were higher in patients with ABGPI titer ≥1 : 10 (P<0.01). These data suggest that these circulating ABGPI may collaborate in the development of atherosclerosis; however, further prospective studies are required to establish a causal relationship.

Saving more lives and limbs: applying a cardiac rehabilitation model of structured exercise to symptomatic peripheral arterial disease

2021 ◽  
pp. 1-8
Author(s):  
Susan Matthews ◽  
Martin Fox ◽  
Sarah Coy ◽  
Jane Whittaker ◽  
Gail Brough ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Cardiac Rehabilitation ◽  
Intermittent Claudication ◽  
Arterial Disease ◽  
Morbidity And Mortality ◽  
Supervised Exercise ◽  
Peripheral Arterial

Background/Aims Peripheral arterial disease is common among those aged 60 years or above and can cause debilitating intermittent claudication. This impacts quality of life and is a marker for increased morbidity and mortality, mainly from cardiovascular disease. Access to recommended exercise programmes for people with symptomatic peripheral arterial disease is poor in most areas of the UK. This study aimed to evaluate the benefits of expanding an established cardiac rehabilitation service to accommodate supervised exercise for people with peripheral arterial disease Methods The study evaluated 11 participants peripheral arterial disease and intermittent claudication who were referred by the Manchester leg circulation service. Participants underwent the programme involving eight weekly 1.5 hour sessions of supervised exercise and cardiovascular education with support, reassurance and motivation. The participants' blood pressure, walking impairment, quality of life, anxiety and depression were monitored and reviewed. Results Overall, the participants' walking distance, intermittent claudication, quality of life and blood pressure had improved. The participants' overall satisfaction with the programme was excellent. The programme also demonstrated clinical and cost-effectiveness. Conclusions A structured, supervised exercise programme can have considerable benefits for people with peripheral arterial disease, improving their symptoms and quality of life. It may also help to reduce the morbidity and mortality risks associated with inactivity in this patient group.

A comparative study of cilostazol and pentoxifylline in intermittent claudication in peripheral arterial disease

2017 ◽  
Vol 12 (1) ◽  
pp. 11
Author(s):  
Chandrashekhar Mahakalkar ◽  
Kshitij Gupta ◽  
Meghali Kaple ◽  
Swati Deshpande ◽  
Prateek Ladhha ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Comparative Study ◽  
Intermittent Claudication ◽  
Arterial Disease ◽  
Peripheral Arterial

Peripheral arterial disease and intermittent claudication in coronary heart disease patients

2021 ◽  
Vol 322 ◽  
pp. 227-232
Author(s):  
Željko Reiner ◽  
Johan De Sutter ◽  
Lars Ryden ◽  
Erkin Mirrakhimov ◽  
Nana Pogosova ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Peripheral Arterial Disease ◽  
Intermittent Claudication ◽  
Arterial Disease ◽  
Peripheral Arterial

scholarly journals Micro-Lightguide Spectrophotometry (O2C) for Lower Limb Perfusion: Effects of Exercise Walking in Claudicants

2019 ◽  
Vol 28 (03) ◽  
pp. 161-166
Author(s):  
Thomas Gyldenløve ◽  
Lise P. Jørgensen ◽  
Torben V. Schroeder
Keyword(s):  
Oxygen Saturation ◽  
Intermittent Claudication ◽  
Ankle Brachial Index ◽  
Exercise Program ◽  
Arterial Disease ◽  
Treadmill Test ◽  
Home Based ◽  
Walking Capacity ◽  
Treadmill Testing ◽  
Peripheral Arterial

Background Exercise walking has improved walking capacity in patients with intermittent claudication without affecting the macrocirculation reflected in ankle pressures. We wanted to investigate microcirculation in the skin related to exercise walking by using Micro-Lightguide Spectrophotometry (O2C). Materials and Methods Twenty-eight patients with intermittent claudication—bilateral in 17—were included in a 12 weeks of structured home-based exercise program. The pain-free and maximal walking distances were determined on a treadmill. Saturation and flow, monitored by O2C, were examined immediately before and after the treadmill test. O2C examination took place before as well as after completion of the exercise program. Ankle–brachial index was obtained before treadmill testing. Results As expected, walking performance improved significantly without affecting ankle pressures. Neither oxygen saturation nor flow, assessed at 2 mm depth, was affected following a 12 weeks of exercise program. We observed a significant decrease in oxygen saturation and flow upon treadmill testing in the both limbs in patients with bilateral peripheral arterial disease (PAD). In contrast, the treadmill test elicited no changes in the opposite and asymptomatic limb in patients with only unilateral PAD. Conclusion The findings suggest that O2C may be used to study microcirculatory changes. However, it is best suited for the study of phenomena resulting in major changes as it eliminates some inherent variability.

scholarly journals Treadmill Exercise and Resistance Training in Patients With Peripheral Arterial Disease With and Without Intermittent Claudication

JAMA ◽  
2009 ◽  
Vol 301 (2) ◽  
pp. 165 ◽  
Author(s):  
Mary M. McDermott ◽  
Philip Ades ◽  
Jack M. Guralnik ◽  
Alan Dyer ◽  
Luigi Ferrucci ◽  
...  
Keyword(s):  
Resistance Training ◽  
Peripheral Arterial Disease ◽  
Intermittent Claudication ◽  
Treadmill Exercise ◽  
Arterial Disease ◽  
Peripheral Arterial

Factors Affecting Peak Vertical Ground Reaction Forces in Running

1986 ◽  
Vol 2 (1) ◽  
pp. 41-49 ◽  
Author(s):  
Edward C. Frederick ◽  
John L. Hagy
Keyword(s):  
Body Mass ◽  
Stride Length ◽  
Reaction Force ◽  
Step Length ◽  
Leg Length ◽  
Vertical Ground Reaction Force ◽  
Anthropometric Parameters ◽  
Factors Affecting ◽  
Reaction Forces ◽  
Vertical Ground

Nine subjects (6 males, 3 females) ranging in body mass from 90.9 to 45.5 kg ran repeated trials across a force platform while being filmed at 50 fps. The subjects ran five barefooted trials at each of three speeds: 3.35, 3.83, and 4.47 m · s−1. Force data were collected on-line and analyzed for the magnitude and temporal characteristics of the initial impact (Fz1) peak and the active (Fz2) peak of vertical ground reaction force (VGRF). Multiple regression and correlation analysis were used to study the relationship between the magnitudes of these kinetic data and kinematic and anthropometric data taken from the film and from measurements of the subjects. The results support the general conclusion that speed and, indirectly, body mass are significant effectors of the magnitudes of Fz1. In addition, other factors that correlate significantly with Fz1 are reciprocal ponderal index (RPI) and stature; half-stride length, step length, leg length, and vertical hip excursion during a half-stride cycle; and hip offset, contact angle, and dorsiflexion angle at contact. Body mass correlates highly with Fz2 (r = 0.95). Other significant factors correlating with Fz2 are RPI, stature, vertical hip excursion, dorsiflexion angle, hip offset, half-stride length, and step length. These data support earlier findings that speed and the effective mass of the leg at contact are important effectors of the magnitude of Fzl. In addition, the kinematic and anthropometric parameters that contribute significantly to the variability in Fzl and F are generally cross-correlated with body size and/or running speed.

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