Effects of Clustered Comorbid Conditions on Walking Capacity in Patients with Peripheral Artery Disease

Farah, Breno Quintella; Ritti‐Dias, Raphael Mendes; Cucato, Gabriel Grizzo; Chehuen, Marcel da Rocha; Barbosa, José Elpídio; Zeratti, Antônio Eduardo; Wolosker, Nelson; Puech-Leão, Pedro

doi:10.1016/j.avsg.2013.01.020

Cited by 23 publications

(19 citation statements)

References 40 publications

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“…Farah et al 17 found clustered comorbid conditions to be associated with lower walking capacity using the maximal-pain method. Barak et al 30 found positive results in improved walking performance in patients with PAD and co-morbid conditions.…”

Section: Future Directionsmentioning

confidence: 98%

“…Cerebrovascular disease was shown to be associated with lower total walking distance. 17 Furthermore, the cluster of hypertension, diabetes, cerebrovascular disease, coronary artery disease and chronic obstructive pulmonary disease was associated with lower claudication distance using the graded maximal treadmill test. 17 Women have a higher rate of mobility loss with PAD due to poorer lower extremity functioning compared to men.…”

Section: Introductionmentioning

confidence: 99%

“…17 Furthermore, the cluster of hypertension, diabetes, cerebrovascular disease, coronary artery disease and chronic obstructive pulmonary disease was associated with lower claudication distance using the graded maximal treadmill test. 17 Women have a higher rate of mobility loss with PAD due to poorer lower extremity functioning compared to men. [11][12][13] Patients with PAD completing supervised exercise training were found to have a higher level of event-free survival compared to patients who did not.…”

Section: Introductionmentioning

confidence: 99%

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Pain-free treadmill exercise for patients with intermittent claudication: Are there gender differences?

et al. 2015

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Intermittent claudication, a common symptom of peripheral arterial disease, results in insufficient blood flow and oxygen supply to lower extremity muscles. Compared to men, women with peripheral arterial disease have a higher rate of mobility loss with peripheral arterial disease due to poorer lower extremity functioning. This study evaluates the effect of supervised pain-free treadmill exercise on improving performance in women with intermittent claudication due to peripheral arterial disease in comparison to men. A total of 26 participants (women, n = 9, 34.62%; mean age = 67.58 ± 5.59 years; averaging 23.46 ± 3.91 visits and 10.46 ± 0.99 weeks in the program) diagnosed with peripheral arterial disease, with symptoms of intermittent claudication, partook in a 45 min treadmill walk, twice per week, below the participant's minimal pain threshold. Female participants' change scores showed 752%, 278% and 115% improvement in mean walking distance, duration and rate, respectively. Men improved 334%, 149% and 80%, respectively. Significant differences (p < 0.05) in pre and post measurements within each group support positive outcomes. No significant differences between groups were observed (Cohen's d effect size > 0.80). Our results suggest that women reap similar benefits from this low-intensity treadmill program in comparison to men.

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Section: Future Directionsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pain-free treadmill exercise for patients with intermittent claudication: Are there gender differences?

et al. 2015

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“…Patients with intermittent claudication have impaired walking capacity 3 , low physical fitness 4, 5 , and many comorbid conditions 6 , all of which reduce quality of life 7 . In addition, these patients have elevated time spent in sedentary behavior 8 .…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Sedentary Behavior in Patients with Intermittent Claudication

Farah¹,

Ritti‐Dias²,

Cucato³

et al. 2016

European Journal of Vascular and Endovascular Surgery

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Objectives Time spent in sedentary behavior has been associated with cardiometabolic risk factor in the general population and in patients with symptomatic peripheral artery disease (PAD). Given the association of sedentary behavior and poor health outcomes, it is important to identify factors associated of sedentary behavior in these patients. The aim of this study was to identify factors associated with the sedentary time in patients with symptomatic PAD. Methods The sample included 297 patients with symptomatic PAD. Sedentary behavior was assessed using a step activity monitor and the patients were divided into tertiles. Demographic data, body mass index, comorbid conditions, and measures of severity of PAD (ankle-brachial index, ischemic window, claudication measurements, peak oxygen uptake and walking economy) were obtained. Results Patients in the highest tertile (i.e., more sedentary) have a higher body mass index and a higher prevalence of diabetes mellitus, metabolic syndrome and obesity than patients in the lowest tertile, whereas their peak walking time, peak oxygen uptake and walking economy were lower (P<.05 for all). Using multiple regression procedures, the factors associated of the sedentary time were male sex (b=0.217, R2=0.180, p=0.001), body mass index (b=0.154, R2=0.059, p=0.013), peak walking time (b=−0.360, R2=0.066, p=<0.001) and walking economy (b=−0.187, R2=0.142, p=0.004). Conclusion In patients with symptomatic PAD, greater time spent in sedentary behavior was found in men, and in patients with higher body mass index, lower peak walking time, and lower walking economy.

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“…Previous studies have shown that walking impairment in patients with claudication is related to factors, such as sex (14), progression of disease (26), co-morbid conditions (9,10) and presence of risk factors (6). Although walking impairment limits the achievement of VT in some patients (12,43), it is not clear what patient characteristics are associated with not reaching VT. Further, it remains undetermined whether the factors that are associated with walking impairment are also associated with VT. Understanding the clinical predictors of the VT achievement in these patients is useful to identify those who need more attention to improve aerobic capacity.…”

Section: Introductionmentioning

confidence: 99%

Clinical Predictors of Ventilatory Threshold Achievement in Patients with Claudication

Farah

Ritti‐Dias

Cucato

et al. 2015

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose Ventilatory threshold (VT) is considered a clinically important marker of cardiovascular function in several populations, including patients with claudication, as it is related to walking capacity and hemodynamics. The purpose of this study was to identify clinical predictors for the VT achievement in intermittent claudication patients. Methods One hundred seventy-seven (n=177) patients with intermittent claudication performed a progressive graded cardiopulmonary treadmill test until maximal claudication pain. Oxygen uptake (VO2) was continuously measured during the test and afterwards VT was visually detected. Clinical characteristics, demographic data, comorbid conditions, and cardiovascular risk factors were obtained. Patients who achieved and did not achieve VT were compared, as well as the workload that VT occurred in the former group. Results VT was achieved in 134 patients (76%) and the mean VO2 at VT for these patients was 10.8 ± 2.4 mL.kg−1.min−1. Patients who did not achieve VT presented lower ankle brachial index (ABI), claudication onset time, peak walking time, and peak VO2, and the proportion of women was higher compared to patients who achieved VT (p<0.05). Multiple linear regression analysis identified that sex (b=0.25, p=0.002), body mass index (b=−0.18, p=0.025), peak walking time (b=0.17, p=0.044), and ABI (b=0.23, p=0.006) were predictors of the VO2 at VT. Conclusion Forty-three patients (24%) with intermittent claudication did not achieve the VT and these patients were mostly women and those with greater severity of disease. Moreover, in those who reached VT, the predictors of poor VT were female sex, high body mass index, low peak walking time, and low ABI.

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Effects of Clustered Comorbid Conditions on Walking Capacity in Patients with Peripheral Artery Disease

Cited by 23 publications

References 40 publications

Pain-free treadmill exercise for patients with intermittent claudication: Are there gender differences?

Pain-free treadmill exercise for patients with intermittent claudication: Are there gender differences?

Factors Associated with Sedentary Behavior in Patients with Intermittent Claudication

Clinical Predictors of Ventilatory Threshold Achievement in Patients with Claudication

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