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Beyond the Patient's Report: Self-Reported, Subjective, Objective and Estimated Walking Disability in Patients with

Nicola Lamberti1, Lorenzo Caruso1, Giovanni Piva2

  • 1Department of Neuroscience and Rehabilitation, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy.

Diagnostics (Basel, Switzerland)
|November 27, 2021
PubMed

Insights

Patients with peripheral artery disease often overestimate their walking ability. A new formula, incorporating factors like diabetes, improves the accuracy of reported claudication distance for better treatment decisions.

Area of Science:

  • Vascular Medicine
  • Biomedical Engineering
  • Clinical Assessment

Background:

  • Peripheral artery disease (PAD) significantly impacts patient mobility and quality of life.
  • Accurate assessment of walking impairment, specifically claudication distance (CD), is crucial for guiding PAD treatment strategies.
  • Patient self-reported claudication distance (SR-CD) may differ from objective clinical measurements, potentially influencing therapeutic choices.

Purpose of the Study:

  • To compare patient-reported claudication distance (SR-CD) with objectively measured values using validated protocols.
  • To develop a formula for more reliable estimation of walking ability in PAD patients.
  • To investigate the correlation between walking performance, muscle deoxygenation, and patient reporting.

Main Methods:

  • Cross-sectional study involving 359 patients with claudication entering a rehabilitation program.
  • Collected SR-CD, 6-minute walk test (6-CD, 6-MWD), and incremental treadmill test (T-CD, T-MWD) data.
  • Utilized near-infrared spectroscopy (NIRS) to measure calf muscle deoxygenation during treadmill testing.

Main Results:

  • SR-CD was significantly overestimated compared to both 6-CD (+155 m) and T-CD (+182 m).
  • SR-CD showed moderate correlations with T-CD (r=0.30), 6-CD (r=0.32), and 6-MWD (r=0.29).
  • A formula adjusted for diabetes reduced patient overestimation by 92%, enhancing reliability.

Conclusions:

  • Patient-reported claudication distance in PAD is generally overestimated.
  • Objective measures like treadmill and 6-minute walk tests provide more accurate assessments of walking limitations.
  • A simple corrective formula can improve the clinical utility of patient-reported walking ability, aiding treatment selection.

Keywords:
claudicationdiabetesexercise testingperipheral artery diseasereliability

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