Walking economy before and after the onset of claudication pain in patients with peripheral arterial disease

Andrew Gardner, Raphael M. Ritti-Dias, Julie A. Stoner, Polly S. Montgomery, Kristy J. Scott, Steve M. Blevins

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: To determine the walking economy before and after the onset of claudication pain in patients with peripheral arterial disease (PAD), and to identify predictors of the change in walking economy following the onset of claudication pain. Methods: A total of 39 patients with PAD were studied, in which 29 experienced claudication (Pain group) during a constant load, walking economy treadmill test (speed = 2.0 mph, grade = 0%) and 10 were pain-free during this test (Pain-Free group). Patients were characterized on walking economy (ie, oxygen uptake during ambulation), as well as on demographic characteristics, cardiovascular risk factors, baseline exercise performance measures, and the ischemic window calculated from the decrease in ankle systolic blood pressure following exercise. Results: During the constant load treadmill test, the Pain group experienced onset of claudication pain at 323 ± 195 seconds (mean ± standard deviation) and continued to walk until maximal pain was attained at 759 ± 332 seconds. Walking economy during pain-free ambulation (9.54 ± 1.42 ml · kg-1 · min-1) changed (P < .001) after the onset of pain (10.18 ± 1.56 ml · kg-1 · min-1). The change in walking economy after the onset of pain was associated with ischemic window (P < .001), hypertension (P < .001), diabetes (P = .002), and height (P = .003). In contrast, the Pain-Free group walked pain-free for the entire 20-minute test duration without a change in walking economy (P = .36) from the second minute of exercise (9.20 ± 1.62 ml · kg-1 · min-1) to the nineteenth minute of exercise (9.07 ± 1.54 ml · kg-1 · min-1). Conclusion: Painful ambulation at a constant speed is associated with impaired walking economy, as measured by an increase in oxygen uptake in patients limited by intermittent claudication, and the change in walking economy is explained, in part, by severity of PAD, diabetes, and hypertension.

Original languageEnglish (US)
Pages (from-to)628-633
Number of pages6
JournalJournal of Vascular Surgery
Volume51
Issue number3
DOIs
StatePublished - Mar 1 2010

Fingerprint

Peripheral Arterial Disease
Walking
Pain
Exercise
Exercise Test
Oxygen
Blood Pressure
Hypertension
Intermittent Claudication
Ankle
Demography
Pain-Free

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Gardner, Andrew ; Ritti-Dias, Raphael M. ; Stoner, Julie A. ; Montgomery, Polly S. ; Scott, Kristy J. ; Blevins, Steve M. / Walking economy before and after the onset of claudication pain in patients with peripheral arterial disease. In: Journal of Vascular Surgery. 2010 ; Vol. 51, No. 3. pp. 628-633.
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abstract = "Purpose: To determine the walking economy before and after the onset of claudication pain in patients with peripheral arterial disease (PAD), and to identify predictors of the change in walking economy following the onset of claudication pain. Methods: A total of 39 patients with PAD were studied, in which 29 experienced claudication (Pain group) during a constant load, walking economy treadmill test (speed = 2.0 mph, grade = 0{\%}) and 10 were pain-free during this test (Pain-Free group). Patients were characterized on walking economy (ie, oxygen uptake during ambulation), as well as on demographic characteristics, cardiovascular risk factors, baseline exercise performance measures, and the ischemic window calculated from the decrease in ankle systolic blood pressure following exercise. Results: During the constant load treadmill test, the Pain group experienced onset of claudication pain at 323 ± 195 seconds (mean ± standard deviation) and continued to walk until maximal pain was attained at 759 ± 332 seconds. Walking economy during pain-free ambulation (9.54 ± 1.42 ml · kg-1 · min-1) changed (P < .001) after the onset of pain (10.18 ± 1.56 ml · kg-1 · min-1). The change in walking economy after the onset of pain was associated with ischemic window (P < .001), hypertension (P < .001), diabetes (P = .002), and height (P = .003). In contrast, the Pain-Free group walked pain-free for the entire 20-minute test duration without a change in walking economy (P = .36) from the second minute of exercise (9.20 ± 1.62 ml · kg-1 · min-1) to the nineteenth minute of exercise (9.07 ± 1.54 ml · kg-1 · min-1). Conclusion: Painful ambulation at a constant speed is associated with impaired walking economy, as measured by an increase in oxygen uptake in patients limited by intermittent claudication, and the change in walking economy is explained, in part, by severity of PAD, diabetes, and hypertension.",
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Walking economy before and after the onset of claudication pain in patients with peripheral arterial disease. / Gardner, Andrew; Ritti-Dias, Raphael M.; Stoner, Julie A.; Montgomery, Polly S.; Scott, Kristy J.; Blevins, Steve M.

In: Journal of Vascular Surgery, Vol. 51, No. 3, 01.03.2010, p. 628-633.

Research output: Contribution to journalArticle

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T1 - Walking economy before and after the onset of claudication pain in patients with peripheral arterial disease

AU - Gardner, Andrew

AU - Ritti-Dias, Raphael M.

AU - Stoner, Julie A.

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AU - Scott, Kristy J.

AU - Blevins, Steve M.

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N2 - Purpose: To determine the walking economy before and after the onset of claudication pain in patients with peripheral arterial disease (PAD), and to identify predictors of the change in walking economy following the onset of claudication pain. Methods: A total of 39 patients with PAD were studied, in which 29 experienced claudication (Pain group) during a constant load, walking economy treadmill test (speed = 2.0 mph, grade = 0%) and 10 were pain-free during this test (Pain-Free group). Patients were characterized on walking economy (ie, oxygen uptake during ambulation), as well as on demographic characteristics, cardiovascular risk factors, baseline exercise performance measures, and the ischemic window calculated from the decrease in ankle systolic blood pressure following exercise. Results: During the constant load treadmill test, the Pain group experienced onset of claudication pain at 323 ± 195 seconds (mean ± standard deviation) and continued to walk until maximal pain was attained at 759 ± 332 seconds. Walking economy during pain-free ambulation (9.54 ± 1.42 ml · kg-1 · min-1) changed (P < .001) after the onset of pain (10.18 ± 1.56 ml · kg-1 · min-1). The change in walking economy after the onset of pain was associated with ischemic window (P < .001), hypertension (P < .001), diabetes (P = .002), and height (P = .003). In contrast, the Pain-Free group walked pain-free for the entire 20-minute test duration without a change in walking economy (P = .36) from the second minute of exercise (9.20 ± 1.62 ml · kg-1 · min-1) to the nineteenth minute of exercise (9.07 ± 1.54 ml · kg-1 · min-1). Conclusion: Painful ambulation at a constant speed is associated with impaired walking economy, as measured by an increase in oxygen uptake in patients limited by intermittent claudication, and the change in walking economy is explained, in part, by severity of PAD, diabetes, and hypertension.

AB - Purpose: To determine the walking economy before and after the onset of claudication pain in patients with peripheral arterial disease (PAD), and to identify predictors of the change in walking economy following the onset of claudication pain. Methods: A total of 39 patients with PAD were studied, in which 29 experienced claudication (Pain group) during a constant load, walking economy treadmill test (speed = 2.0 mph, grade = 0%) and 10 were pain-free during this test (Pain-Free group). Patients were characterized on walking economy (ie, oxygen uptake during ambulation), as well as on demographic characteristics, cardiovascular risk factors, baseline exercise performance measures, and the ischemic window calculated from the decrease in ankle systolic blood pressure following exercise. Results: During the constant load treadmill test, the Pain group experienced onset of claudication pain at 323 ± 195 seconds (mean ± standard deviation) and continued to walk until maximal pain was attained at 759 ± 332 seconds. Walking economy during pain-free ambulation (9.54 ± 1.42 ml · kg-1 · min-1) changed (P < .001) after the onset of pain (10.18 ± 1.56 ml · kg-1 · min-1). The change in walking economy after the onset of pain was associated with ischemic window (P < .001), hypertension (P < .001), diabetes (P = .002), and height (P = .003). In contrast, the Pain-Free group walked pain-free for the entire 20-minute test duration without a change in walking economy (P = .36) from the second minute of exercise (9.20 ± 1.62 ml · kg-1 · min-1) to the nineteenth minute of exercise (9.07 ± 1.54 ml · kg-1 · min-1). Conclusion: Painful ambulation at a constant speed is associated with impaired walking economy, as measured by an increase in oxygen uptake in patients limited by intermittent claudication, and the change in walking economy is explained, in part, by severity of PAD, diabetes, and hypertension.

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