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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
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Exercise treadmill testing in patients with claudication, with and without diabetes.

G Mahé1, N Ouedraogo, G Leftheriotis

  • 1Department of Physiology and Vascular Investigations, University Hospital UMR INSERM 771 - CNRS 6214, France.

Diabetic Medicine : a Journal of the British Diabetic Association
|February 12, 2011
PubMed
Summary

Patients with diabetes experience greater treadmill limitations and more non-limb symptoms compared to those without diabetes, despite similar self-reported walking ability. This highlights the impact of diabetes on peripheral artery disease progression.

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Area of Science:

  • Vascular Medicine
  • Diabetology
  • Exercise Physiology

Background:

  • Peripheral artery disease (PAD) is a common complication of diabetes, affecting walking capacity and quality of life.
  • Vascular-type claudication, characterized by leg pain during exercise, is a hallmark symptom of PAD.
  • Diabetes may influence the presentation and severity of PAD-related symptoms and functional limitations.

Purpose of the Study:

  • To compare the symptoms and objective walking capacities of patients with and without diabetes who report vascular-type claudication.
  • To investigate differences in exercise-induced ischemia and symptom patterns between diabetic and non-diabetic PAD patients.

Main Methods:

  • A cohort of 230 patients with diabetes and 982 patients without diabetes reporting claudication was studied.
  • Data collected included self-reported maximal walking distance, treadmill test performance (distance, speed, slope), and exercise transcutaneous oxygen pressure (TcpO2) DROP index.
  • Analysis focused on exercise-induced proximal and distal symptoms in relation to ischemia (DROP value < -15 mmHg).

Main Results:

  • Maximal walking distance on treadmill was significantly lower in patients with diabetes (261 m) compared to those without (339 m).
  • Patients with diabetes exhibited more distal ischemia (38% vs. 29%) but similar proximal ischemia compared to non-diabetic patients.
  • A higher prevalence of non-limb symptoms was observed in patients with diabetes (29.6%) versus those without (18.3%).

Conclusions:

  • Diabetic patients with claudication demonstrate greater functional limitation on treadmill testing and report more non-limb symptoms than their non-diabetic counterparts.
  • Objective measurements confirm more distal ischemia in diabetic PAD patients, underscoring the specific impact of diabetes on PAD.
  • Treadmill testing, particularly when incorporating TcpO2 measurements, is valuable for assessing PAD severity in patients with diabetes.