Effects of intermittent claudication due to arterial disease on pain-free gait

Evangelopoulou, Eftychia; Jones, Richard; Jameel, Mohideen; Boyd, Peter; Nester, Christopher

doi:10.1016/j.clinbiomech.2021.105309

Cited by 2 publications

(15 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…During the early stance phase, peak hip extensor torque was significantly reduced during self-selected 33,39,45–47 and fast overground walking 46 in patients with PAD. This implies decreased concentric contractions of the hip extensors (gluteal muscles).…”

Section: Methods Of Biomechanical Assessmentmentioning

confidence: 94%

“…35 A recent study showed a significant reduction in maximum vertical GRF during the early and late stance in patients with PAD compared to healthy controls. 39 Flattening of the vertical ground reaction force curve suggests reduced vertical movement in the body’s center of mass. Another study 40 performed frequency domain analysis of the GRF to assess the frequency content in healthy subjects and patients with PAD.…”

Section: Methods Of Biomechanical Assessmentmentioning

confidence: 99%

“…32,46 Some studies did not find a significant difference in the ankle dorsiflexor torque compared to healthy controls. 33,34,39,47 In general, weakness of the hip and knee extensors and ankle dorsiflexors in early stance implies diminished control of weight acceptance, which translates into impaired transfer of momentum across the remaining stance phase of walking in patients with PAD.…”

Section: Methods Of Biomechanical Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

A biomechanical perspective on walking in patients with peripheral artery disease

et al. 2023

View full text Add to dashboard Cite

The most common symptom of peripheral artery disease (PAD) is intermittent claudication, which consists of debilitating leg pain during walking. In clinical settings, the presence of PAD is often noninvasively evaluated using the ankle–brachial index and imaging of the arterial supply. Furthermore, various questionnaires and functional tests are commonly used to measure the severity and negative effect of PAD on quality of life. However, these evaluations only provide information on vascular insufficiency and severity of the disease, but not regarding the complex mechanisms underlying walking impairments in patients with PAD. Biomechanical analyses using motion capture and ground reaction force measurements can provide insight into the underlying mechanisms to walking impairments in PAD. This review analyzes the application of biomechanics tools to identify gait impairments and their clinical implications on rehabilitation of patients with PAD. A total of 18 published journal articles focused on gait biomechanics in patients with PAD were studied. This narriative review shows that the gait of patients with PAD is impaired from the first steps that a patient takes and deteriorates further after the onset of claudication leg pain. These results point toward impaired muscle function across the ankle, knee, and hip joints during walking. Gait analysis helps understand the mechanisms operating in PAD and could also facilitate earlier diagnosis, better treatment, and slower progression of PAD.

show abstract

Section: Methods Of Biomechanical Assessmentmentioning

confidence: 94%

Section: Methods Of Biomechanical Assessmentmentioning

confidence: 99%

Section: Methods Of Biomechanical Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

A biomechanical perspective on walking in patients with peripheral artery disease

et al. 2023

View full text Add to dashboard Cite

show abstract

“…In some studies, researchers have compared the lower limb muscle bioelectrical activity between PAD patients and healthy controls [ 11 , 18 ]. However, there are no studies in which changes in the bioelectrical activity of the lower limb muscles caused by the walking training program would be comprehensively examined.…”

Section: Discussionmentioning

confidence: 99%

“…In prolonged muscle contractions, the amplitude of sEMG increases in relation to the increasing number of newly recruited motor units, which replace those previously active [ 16 , 17 ]. In some studies, bioelectrical activity of the lower limb muscles has been compared between PAD patients and healthy controls [ 11 , 18 ]. To our knowledge, there is no existing study in which changes in bioelectrical activity of the lower limb muscles, due to implementing a walking training program in PAD patients, would be examined using surface electromyography (sEMG).…”

Section: Introductionmentioning

confidence: 99%

The Influence of Treadmill Training on the Bioelectrical Activity of the Lower Limb Muscles in Patients with Intermittent Claudication

Mika

Oleksy

et al. 2022

JCM

View full text Add to dashboard Cite

Aim: Intermittent claudication is the most common symptomatic manifestation of peripheral arterial disease (PAD), presenting as ischemic leg muscle pain and gait dysfunction. The aim of this study was to evaluate the changes in bioelectrical activity of the lower limb muscles activity in claudicating patients over a 12-week period of supervised treadmill training and to verify the hypothesis as to which muscles of lower limbs are activated by training treatment—the proximal, as compensatory mechanism, or the distal, which are the most ischemic. Methods: The study comprised 45 patients aged 60–70 years (height 168.8 ± 6.8 cm, weight 78.9 ± 9.2 kg) with PAD and unilateral intermittent claudication (Fontaine stage IIa/IIb), who participated in a 12-week supervised treadmill training program. Surface electromyography (sEMG) of the gastrocnemius lateralis (GaL), gastrocnemius medialis (GaM), tibialis anterior (TA), biceps femoris (BF), rectus femoris (RF) and gluteus medius (GM) muscles in the claudicated leg were continuously measured during the treadmill test. The average mean amplitude and mean amplitude range of the sEMG signal were analyzed. Results: During the treadmill test, after 12 weeks of training, the average mean amplitude of the GM (105 ± 43 vs. 74 ± 38%, p = 0.000008, ES = 0.76), BF (41 ± 22 vs. 33 ± 12%, p = 0.006, ES = 0.45) and GaM (134 ± 50 vs. 114 ± 30%, p = 0.007, ES = 0.48) muscles was significantly lower compared with baseline. The mean amplitude range was significantly decreased after 12 weeks of training in the GM (229 ± 64 vs. 181 ± 62%, p = 0.008, ES = 0.77) and BF (110 ± 69 vs. 84 ± 31%, p = 0.0002, ES = 0.48) muscles. After 12 weeks of training, the mean amplitude range of the TA muscle was significantly higher compared with baseline (104 ± 46 vs. 131 ± 53%, p = 0.001, ES = 0.54), but without significant changes in the average mean amplitude value. The most favorable changes, suggesting the lowest muscle fatigue and the highest walking capacity, were found in patients with the longest walking time. Conclusions: The obtained results may suggest that after 12 weeks of treadmill training, beneficial changes occurred in both the proximal and distal muscles. Therefore, greater foot plantar flexion and stronger push-off as well as greater hip extension may be considered the main mechanisms of observed gait pattern improvement. It may also be suggested that the therapy of gait alterations in patients with PAD should be focused not only on calf muscle pump improvement, but also on proximal hip extensor strengthening.

show abstract

Effects of intermittent claudication due to arterial disease on pain-free gait

Cited by 2 publications

References 37 publications

A biomechanical perspective on walking in patients with peripheral artery disease

A biomechanical perspective on walking in patients with peripheral artery disease

The Influence of Treadmill Training on the Bioelectrical Activity of the Lower Limb Muscles in Patients with Intermittent Claudication

Contact Info

Product

Resources

About