Isokinetic Strength and Endurance in Proximal and Distal Muscles in Patients With Peripheral Artery Disease

Câmara, Lucas Caseri; Ritti‐Dias, Raphael Mendes; Menêses, Annelise Lins; Greve, Júlia Maria D’Andréa; Santarém, José Maria; Forjaz, C. L. M.; Puech-Leão, Pedro; Wolosker, Nelson

doi:10.1016/j.avsg.2012.03.012

Cited by 34 publications

(46 citation statements)

References 25 publications

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“…1 Complaints of claudication, defined as pain or cramping with walking, or other atypical leg symptoms such as fatigue with activity are reported by up to 60% of individuals with PAD. 2 Consequently, individuals with PAD also commonly experience limitations across all domains of function including slow gait speeds, 3 balance dysfunction, 4 decreased leg strength, 5 and a sedentary lifestyle. 3 These result in low ambulatory activity levels 6 and the associated potential for weight gain, obesity 7,8 and worsening PAD.…”

Section: Introductionmentioning

confidence: 99%

Changes in Function After a 6-Month Walking Intervention in Patients With Intermittent Claudication Who Are Obese or Nonobese

Addison

Ryan

Prior

et al. 2017

Journal of Geriatric Physical Therapy

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Background and Purpose Both obesity and peripheral artery disease (PAD) limit function and may work additively to reduce mobility. The purpose of this study was to compare the effects of a 6-month, center-based walking program on mobility function between adults who are weight-stable obese and non-obese with PAD. Methods This is a secondary data analysis of two combined studies taken from previous work. Fifty-three adults with PAD and intermittent claudication participated in 6-months of treadmill training or standard of care. Patients were divided into 4-groups for analyses: Exercise non-obese (Ex), Exercise obese (ExO), standard of care non-obese (SC) and standard of care obese (SCO). Mobility was assessed by a standardized treadmill test to measure claudication onset time (COT) and peak walking time (PWT) as well as the distance walked during a six-minute walk (6MWD) test. Results There was a significant (p<0.001) interaction (intervention × obesity) effect on 6MWD, wherein both exercise groups improved (Ex=7%, ExO=16%; p<0.02), the SC group did not change (0.9%; p>0.05), and the SCO group tended to decline (−18%; p=0.06). Both exercise intervention groups significantly improved COT (Ex=92%, ExO=102%; p<0.01) and PWT (Ex=54%, ExO=103%; p<0.001). There was no change (p>0.05) in either standard of care group. Conclusions Individuals who are obese and non-obese with PAD made similar improvements following a 6-month, center-based walking program. However, patients who are obese with PAD and do not exercise may be susceptible to greater declines in mobility. Exercise may be particularly important in patients who are obese with PAD to avoid declines in mobility.

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Section: Introductionmentioning

confidence: 99%

Changes in Function After a 6-Month Walking Intervention in Patients With Intermittent Claudication Who Are Obese or Nonobese

Addison

Ryan

Prior

et al. 2017

Journal of Geriatric Physical Therapy

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“…Regarding CVD, only ABI correlated independently to ET, thus suggesting that the increase in muscle fatigability associated with CVD may be explained, at least partly, by the presence of PAD. Although this is the first study evaluating the correlations between T2DM and CVD on muscle fatigability, the medical literature does support the concept that higher muscle fatigue may occur in patients suffering from CAD and PAD compared with healthy controls. In CAD patients, two studies assessing muscle fatigue with an experimental protocol similar to ours reported a shorter ET (approximately 29%) at the quadriceps muscle and attributed this defect to pathophysiological changes occurring in vascular and muscular systems .…”

Section: Discussionmentioning

confidence: 81%

“…Conversely, the only study which has addressed the effect of both DPN and T2DM on muscle fatigue supports the concept that muscle fatigue is not aggravated by DPN . A number of studies have also shown that individuals suffering from coronary artery disease (CAD) and PAD are characterized by a higher fatigability in the knee and ankle muscles. Moreover, it is well recognized that chronic kidney disease (CKD) is responsible for a progressive deterioration of muscle performance, which is characterized by an impairment of muscle strength and fatigue .…”

Section: Introductionmentioning

confidence: 94%

Muscle fatigability in patients with type 2 diabetes: relation with long‐term complications

Orlando

Sacchetti

D’Errico

et al. 2019

Diabetes Metabolism Res

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Aims: It is unclear whether long-term complications play a role in muscle fatigue characteristic of patients with type 2 diabetes mellitus (T2DM). The purpose of this study was to investigate the association between muscle fatigability and microvascular and macrovascular complications in patients with T2DM. Methods:One-hundred forty-six patients with T2DM (80 males, 66 females, aged 66.9 ± 7.9 years) were recruited. Maximal voluntary contraction (MCV) and endurance time (ET, 50% of the MVC) were assessed at the knee extensor muscles with an isometric dynamometer. Univariate and multivariate correlations of ET values with diabetic complications, a wide range of surrogate measures of these sequelae, and cardiovascular risk factors were examined.

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“…The myopathy of PAD is likely a key contributor to the observed weakness of the dorsiflexor, and hip extensor muscle groups [47,48]. Perhaps more important for forward progression is the inability of the ankle and knee to generate force at the rate of healthy individuals, as reflected in reduced power generation during mid and late stance [49].…”

Section: Discussionmentioning

confidence: 99%

Gait deficiencies associated with peripheral artery disease are different than chronic obstructive pulmonary disease

et al. 2017

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Objective Previous studies have indicated that patients with peripheral artery disease (PAD), display significant differences in their kinetic and kinematic gait characteristics when compared to healthy, aged-matched controls. The ability of patients with chronic obstructive pulmonary disease (COPD) to ambulate is also limited. These limitations are likely due to pathology-driven muscle morphology and physiology alterations establish in PAD and COP, respectively. Gait changes in PAD were compared to gait changes due to COPD to further understand how altered limb muscle due to disease can alter walking patterns. Both groups were independently compared to healthy controls. It was hypothesized that both patients with PAD and COPD would demonstrate similar differences in gait when compared to healthy controls. Methods Patients with PAD (n =25), patients with COPD (n =16), and healthy older control subjects (n =25) performed five walking trials at self-selected speeds. Sagittal plane joint kinematic and kinetic group means were compared. Results Peak values for hip flexion angle, braking impulse, and propulsive impulse were significantly reduced in patients with symptomatic PAD compared to patients with COPD. After adjusting for walking velocity, significant reductions (p < 0.05) in the peak values for hip flexion angle, dorsiflexor moment, ankle power generation, propulsion force, braking impulse, and propulsive impulse were found in patients with PAD compared to healthy controls. No significant differences were observed between patients with COPD and controls. Conclusions The results of this study demonstrate that while gait patterns are impaired for patients with PAD, this is not apparent for patients with COPD (without PAD). PAD (without COPD) causes changes to the muscle function of the lower limbs that affects gait even when subjects walk from a fully rested state. Altered muscle function in patients with COPD does not have a similar effect.

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Isokinetic Strength and Endurance in Proximal and Distal Muscles in Patients With Peripheral Artery Disease

Cited by 34 publications

References 25 publications

Changes in Function After a 6-Month Walking Intervention in Patients With Intermittent Claudication Who Are Obese or Nonobese

Changes in Function After a 6-Month Walking Intervention in Patients With Intermittent Claudication Who Are Obese or Nonobese

Muscle fatigability in patients with type 2 diabetes: relation with long‐term complications

Gait deficiencies associated with peripheral artery disease are different than chronic obstructive pulmonary disease

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