Objective evaluation of upper limb claudication: use of isokinetic dynamometry

Area of Science:

• Vascular Surgery
• Exercise Physiology
• Biomechanical Engineering

Background:

• Occlusive arterial disease in upper limbs, particularly subclavian artery occlusive disease, can cause significant functional limitations.
• Objective and reproducible methods are needed to assess this impairment.

Purpose of the Study:

• To present a practical and reproducible stress test for evaluating functional limitation due to upper limb occlusive arterial disease.
• To utilize an isokinetic dynamometer for objective assessment.

Main Methods:

• A cohort of 23 patients with unilateral subclavian artery occlusive disease (group 1) and 7 controls (group 2) were studied.
• An isokinetic dynamometer (CYBEX 6000) was used to assess elbow flexion and extension.
• Tests involved series of repetitions until limb exhaustion or a maximum of 270 repetitions.

Main Results:

• No significant functional performance difference was found between healthy limbs in both groups.
• Limbs with subclavian artery occlusive disease showed significantly lower performance parameters compared to control limbs (P < 0.05).
• These objective differences allow quantification of functional limitation caused by ischemia.

Conclusions:

• A novel stress test using an isokinetic dynamometer has been developed for subclavian artery occlusive disease.
• This test can aid in classifying patients based on functional impairment.
• It facilitates better therapeutic choices and objective comparison of treatment outcomes.