Alterations in gait parameters with peripheral artery disease: The importance of pre-frailty as a confounding variable

Abstract

reported results are inconsistent when comparing gait parameters between PAD patients and healthy controls. This inconsistency may be due to frailty, which is highly prevalent among PAD patients. To address this hypothesis, 41 participants, 17 PAD (74±8 years) and 24 agedmatched controls (76±7 years) were recruited. Gait was objectively assessed using validated wearable sensors. Analysis of covariate (ANCOVA) tests were used to compare gait parameters between PAD and non-PAD groups, considering age, gender, and body mass index as covariates, while stratified based on frailty status. According to Fried frailty index, 47% of PAD and 50% of control participants were non-frail and the rest were classified as pre-frail. Within non-frail participants, gait speed, body sway during walking, stride length, gait cycle time, double-support, knee range of motion, speed variability, mid-swing speed, and gait initiation were significantly different between PAD and control groups (effect size d = 0.75±0.43). While in the pre-frail group, most of gait differences were diminished except for gait initiation and gait variability. Results also suggest that gait initiation is the most sensitive parameter for detecting gait impairment in PAD participants when compared to controls regardless of frailty status (d = 1.30-1.41; p<0.050). The observed interaction effect between frailty and PAD on gait parameters confirms the importance of assessing functionality in addition to age to provide more consistency in detecting motor performance impairments due to PAD.

The Impact of Frailty on Outcomes of Elderly Patients After Major Vascular Surgery: A Systematic Review and Meta-analysis

“…Finally, some studies proposed the definition of "pre-frailty," an early and reversible stage of frailty, and ascertained its predictive value for cardiovascular diseases in community dwelling elderly people. 45,46 Future studies may be needed to investigate whether pre-frailty will affect the prognosis of patients who underwent vascular surgery.…”

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

“…), PAD patients are frequently affected by diabetes. Nevertheless, even if diabetes, with or without neuropathy, can induce gait alterations 37 , there was no change in gait parameters in PAD patients when they were adjusted for diabetes 38 . Based upon these observations, we deliberately chose not to exclude patients with diabetes.…”

Digital Biomarkers of Poor Gait and Balance in Diabetic Foot, Measurable by Wearables: A Review of Literature

“…After evaluating eligibility for the other 22 articles, two more papers were excluded based on full-text review. Consequently, 20 papers were included in the current review [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43].…”