Document Detail


Gait variability is altered in patients with peripheral arterial disease.
MedLine Citation:
PMID:  19217749     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Claudication is the most common presentation of peripheral arterial disease (PAD), producing significant ambulatory compromise. Claudicating patients, most of whom are elderly, have reduced mobility and poor health outcomes, including an increased risk of falls. The gait of elderly fallers is characterized by increased variability. Increase in the variability of the locomotor system makes the gait more noisy and unstable. The purpose of this study is to investigate gait variability in patients with PAD.
METHODS: Nineteen symptomatic PAD patients (age, 63.6 +/- 9.8 years; body mass, 82.1 +/- 18.5 kg; height, 1.71 +/- 0.06 m) walked on a treadmill in the absence of pain or claudication symptoms while joint flexion and extension kinematics were captured. Results were compared with results obtained from 17 matched healthy controls (age, 65.2 +/- 12.5 years; body mass, 82.0 +/- 25.9.5 kg; height, 1.73 +/- 0.08 m). Relative joint angles were calculated for the ankle, knee, and hip flexion/extension, and the stride-to-stride variability of joint flexion and extension was calculated from at least 30 consecutive footfalls. Variability was expressed using the largest Lyapunov exponent, standard deviation, and coefficient of variation. Independent t tests were used to compare gait variability between groups.
RESULTS: Symptomatic PAD patients had significantly higher largest Lyapunov exponent values and coefficient of variation values for all joints, and higher standard deviation values at the ankle and the hip (P < .05).
CONCLUSION: Symptomatic PAD patients have increased gait variability at the ankle, knee, and hip joints at baseline ambulation in the absence of claudication pain. Our findings indicate significant baseline deterioration in the locomotor system of symptomatic PAD patients. This deterioration results in increased noise and instability of gait and is a potential contributing factor to the falls and mobility problems experienced by symptomatic PAD patients.
Authors:
Sara A Myers; Jason M Johanning; Nick Stergiou; Rolando I Celis; Leon Robinson; Iraklis I Pipinos
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Publication Detail:
Type:  Journal Article     Date:  2009-02-14
Journal Detail:
Title:  Journal of vascular surgery     Volume:  49     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-03     Completed Date:  2009-04-20     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  924-931.e1     Citation Subset:  IM    
Affiliation:
Nebraska Biomechanics Core Facility, University of Nebraska Medical Center, Omaha, Neb, USA.
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MeSH Terms
Descriptor/Qualifier:
Accidental Falls
Aged
Ankle Joint / physiopathology
Biomechanics
Case-Control Studies
Female
Gait*
Hip Joint / physiopathology
Humans
Knee Joint / physiopathology
Male
Middle Aged
Mobility Limitation
Peripheral Vascular Diseases / physiopathology*
Range of Motion, Articular
Walking*
Comments/Corrections
Comment In:
J Vasc Surg. 2009 Oct;50(4):976; author reply 976-7   [PMID:  19786247 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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