Pedalator assessment of occlusive arterial disease of the lower extremities

Use of the Pedalator instead of the treadmill in the assessment of occlusive arterial disease of the lower extremities has been evaluated. The following aspects were assessed: (1) The effect on the cardiovascular system in terms of brachial arterial pressure, pulse rate, and oxygen consumption (VO2) during exercise in 5 health volunteers; (2) emg activity of the tibialis anterior and gastrocnemius muscles during exercise in the same 5 volunteers; and (3) postexercise ankle pressure changes in 10 subjects with angiographically proven occlusive arterial diseases of the lower extremities. For comparable degrees of VO2, the changes in brachial arterial pressure and pulse rate were similar. However, the maximum workload and effect on the cardiovascular system with the Pedalator were self-limiting. The emg acticity of tibialis anterior and gastrocnemius muscles was greater with the Pedalator. Average exercise time required to produce calf pain was 5 minutes with the Pedalator and 2.8 minutes with the treadmill. When the systolic pressure indexes before and after exercise was compared in 3 groups of limbs (11 with complete, 8 with partial, and 1 with no occlusion), both forms of exercise produced a significant degree of reduction in the systolic pressure index in all limbs except the normal one. The Pedalator exercise was associated with less elevation of brachial arterial pressure. Therefore, the Pedalator should be used whenever the least elevation of brachial arterial pressure is desirable during the assessment of occlusive arterial disease.