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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
Published on: December 11, 2013
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Gait changes after supervised exercise training in patients with symptomatic lower extremity peripheral artery
Stefano Lanzi1, Joël Boichat1, Luca Calanca1
1Heart and Vessel Department, Division of Angiology, Lausanne University Hospital, Lausanne, Switzerland.
Vascular Medicine (London, England)
|February 11, 2021
Summary
Supervised exercise training significantly improved walking distance in peripheral artery disease (PAD) patients. Changes in foot contact gait phases, not overall measures, correlated with improved pain-free walking, suggesting a mechanism for delayed claudication.
Area of Science:
- Vascular Medicine
- Exercise Physiology
- Biomechanics
Background:
- Peripheral artery disease (PAD) significantly impairs walking ability and quality of life.
- Symptomatic lower extremity PAD often leads to claudication, limiting daily activities.
- Supervised exercise training (SET) is a primary non-pharmacological intervention for PAD.
Purpose of the Study:
- To evaluate the impact of a 3-month SET program on walking performance in PAD patients.
- To analyze spatiotemporal gait parameter changes following SET in symptomatic PAD.
- To identify correlations between gait modifications and improvements in walking distance.
Main Methods:
- A single-arm prospective cohort study involving 27 patients with Fontaine stage II PAD.
- Constant-load treadmill testing pre- and post-SET to measure pain-free walking distance (PFWD) and maximal walking distance (MWD).
- Assessment of spatiotemporal gait parameters and ankle-brachial/toe-brachial indices (ABI/TBI).
Main Results:
- SET significantly increased PFWD (+68%) and MWD (+79%) (p<0.001).
- ABI and TBI showed no significant changes post-SET.
- Significant alterations in stance subphases were observed: longer loading response and foot-flat, shorter push-off phases.
- Positive correlation between foot-flat phase changes and PFWD improvement (r=0.43, p=0.03).
- Negative correlation between push-off phase changes and PFWD (r=-0.39, p=0.05).
Conclusions:
- SET effectively enhances walking distance in patients with symptomatic lower extremity PAD.
- Specific temporal gait modifications during the foot contact phase, particularly the foot-flat phase, are associated with improved pain-free walking.
- These gait alterations may represent a key mechanism underlying the benefits of SET for PAD patients.
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