Pharmacological Treatment of Intermittent Claudication Does Not Have a Significant Effect on Gait Impairments During Claudication Pain

Yentes, Jennifer M.; Huisinga, Jessie M.; Myers, Sara A.; Pipinos, Iraklis I.; Johanning, Jason M.; Stergiou, Nicholas

doi:10.1123/jab.28.2.184

Cited by 9 publications

(4 citation statements)

References 51 publications

(66 reference statements)

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“…Precise assessment of gait biomechanics has proven a useful way to assess differences versus healthy counterparts, determine mechanisms responsible for gait alterations, and evaluate treatment effectiveness in patients with PAD. 56–58 Therefore, determining the presence of PAD without the need to induce leg pain will be beneficial for assessing the risk of disease progression and allow early interventions and therapies to prevent or lessen the consequences of the disease. A recent study successfully implemented a machine learning model on gait biomechanics data to identify presence of PAD.…”

Section: Discussionmentioning

confidence: 99%

A biomechanical perspective on walking in patients with peripheral artery disease

et al. 2023

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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.

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Section: Discussionmentioning

confidence: 99%

A biomechanical perspective on walking in patients with peripheral artery disease

et al. 2023

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“…For example, the introduction of moderate-intensity walking training may lead to an increase in the distance covered by patients [34, 35]. Pharmacological treatment of IC does not have a significant effect on gait impairments [36, 37]. A number of reviews have reported the influence of exercise therapy for the treatment of patients with IC [25, 38–45].…”

Section: Discussionmentioning

confidence: 99%

Changes in Gait Variables in Patients with Intermittent Claudication

Pietraszewski

Woźniewski

Jasiński

et al. 2019

BioMed Research International

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Objective. Intermittent claudication (IC) is a pathological symptom with a particular effect on human gait patterns. Therefore, analyzing these patterns can facilitate rehabilitation or treatment through comparison of the values of kinematic and kinetic variables of patients with the normal values of healthy people. Therefore, the aim of this study was to find differences in the values of gait variables between patients with IC and healthy people. Methods. The study included 98 patients diagnosed with peripheral arterial disease with IC. The patients traveled a distance of 6 m at a voluntary gait velocity. Ground reaction forces while the foot contacted the ground and kinematic variables of lower limb movements were recorded. The values of normal gait variables were computed based on the results obtained in a group of 30 healthy people. Results. Patients used a gait velocity below the norm for healthy people. The velocity during the lower limb swing and the step and stride length in patients with IC were below the norm. Differences were also found in the ranges of motion between patients with IC and healthy people for the pelvic obliquity, pelvic rotation, hip flexion-extension, hip abduction-adduction, hip internal-external rotation, knee flexion-extension, ankle dorsi-plantar flexion, and foot progression angles. Conclusions. The presented kinematic and kinetic characteristics measured by gait variables suggest differences between patients with IC and healthy people. Considering kinematic and kinetic gait variables during the rehabilitation process would facilitate the development of a more economic gait technique (with increased stride length and range of motion in the lower limb joints) to obtain the desired rehabilitation effects. Patients with IC should receive rehabilitation oriented towards improving mobility and increasing muscle strength in selected lower limb joints to increase gait velocity and stride length.

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“…One promising approach concerns the intermittent pneumatic compression (IPC), which determines an improvement in walking distance without claudication and the ABI after exercise [59]. Classically, this type of treatment is used in the phlebologic therapy for the treatment of venous leg ulcers, prophylaxis of deep vein thrombosis, while in lymphology it is used for the treatment of lymphedema [60][61][62].…”

Section: New (Stem Cell and Gene Therapy) And Alternative Therapiesmentioning

confidence: 99%

Main Findings on Therapeutic Management of Lower Extremity Artery Disease

Carbonara¹,

Ciccone²

2015

Cardiol Pharmacol

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Atherosclerosis can involve several areas, resulting in various degrees of the vascular disease. Patients with peripheral arterial disease of the lower limbs (LEAD, lower extremity artery disease) represent a significant percentage of the vascular disease population. Therefore, the main objective of physicians who examine a patient with LEAD is to intervene on the risk factors (common to all cardiovascular diseases) using different therapeutic approaches: exercise, specific drugs and ultimately the surgical or percutaneous revascularization. The aim of this review is to summarize the key findings and the updates in the field of diagnostic methods and non-surgical therapeutic approaches for this disease.

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Pharmacological Treatment of Intermittent Claudication Does Not Have a Significant Effect on Gait Impairments During Claudication Pain

Cited by 9 publications

References 51 publications

A biomechanical perspective on walking in patients with peripheral artery disease

A biomechanical perspective on walking in patients with peripheral artery disease

Changes in Gait Variables in Patients with Intermittent Claudication

Main Findings on Therapeutic Management of Lower Extremity Artery Disease

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