The Effects of Peripheral Vascular Disease on Gait

Abstract

This study wasdesignedto determine whetherpatients withperipheralvasculardisease(PVD)havegait abnormalities. A previousstudy on humans with PVDfound no abnormalities whereas significantgait changes wereseen with a rat model of PVD. The studypopulationwascomprisedof10 controlsand 9 subjectswith PVD (allmale). The PVDgroup haddocumentedpain in one or both legs while walking.Subjects rangedin agefrom 55-92 years ofage, with a mean age of69 in the PVD group and 70 in the controlgroup. The GaitMat11system was used to measure both spatialand temporal variables ofgait. Subjects walkedacrossthe mat,four to six times, at their comfortable walking speed. The PVD group then walkedon a treadmilluntil they experienced moderateclaudication pain andfelt they had to stop(painlevels between6 and 8, with maximal pain at level 10).Controlgroup walkedon a treadmillfor 10 minutes withoutpain. All subjectsrepeated the gait testson the GaitMat11systemimmediatelyafter treadmillwalking.Claudication pain persistedin the PVD group during the second gait test. The PVD group was not different than controlgroup in any ofthe measured variables on the first test (p valuesfrom .35 to .99). Differencescores(post-minus pre-treadmillwalking)for PVDgroup weresignificantly differentthan thosefor controlgroup on 8 of11 variables (p values< .005). The primaryresponsein PVD subjects wasreduced walkingspeed(1.02± 0.16to 0.94 ± 0.16mls) and reducedsteplength (0.60± 0.08to 0.57± 0.09mls), whereas controlsubjects increasedtheir speed(1.09± 0.17to 1.19 ± 0.19mls)and steplength (0.63± 0.10to 0.67 ± 0.10mls).No asymmetriesin gait weremeasuredin eithergroup, eitherbefore or after treadmillwalking.In conclusion,PVD subjects were not differentin gait whilerested, but responded to claudication pain by reducingpreferredwalkingspeedand stepsize.

Gait Alterations Associated with Walking Impairment in People with Peripheral Arterial Disease with and without Intermittent Claudication

“…Two recent studies assessed gait parameters in men with intermittent claudication. 18,19 Scherer et al studied 19 PAD patients and 11 non-PAD patients who walked 20 meters at an ordinary pace on a level surface. 17 PAD patients had slower cadence, shorter step length, and, as a result, slower walking velocity than non-PAD patients.…”

Increased skeletal muscle mitochondrial free radical production in peripheral arterial disease despite preserved mitochondrial respiratory capacity

“…Subjects reported to the laboratory for testing in a fasted state (>8 h postprandial) and refrained from caffeine or strenuous exercise prior to the studies (>24 h). All subjects performed a 10 m walk test as a clinical assessment of overall physical function during the initial screening visit, as previously described (McCully, Leiper, Sanders, & Griffin, 1999;Peters, Fritz, & Krotish, 2013).…”

Treatment with Pharmacological Agents in Peripheral Arterial Disease Patients Does Not Result in Biomechanical Gait Changes

“…This resulted in "pure" PAD patients. Examination of PAD patients without gait affecting comorbidities is almost never seen in studies examining PAD populations because subjects are only screened for an ankle brachial index of less than 0.90 to ensure that they have PAD (Gardner & Montgomery, 2001a, 2001bMcCully et al, 1999;McDermott et al, 2001McDermott et al, , 2003.…”