Gait variability in patients with peripheral arterial disease

PAD是全身性动脉粥样硬化的表现，其特征在于动脉粥样硬化性阻塞， 供应腿部的动脉跛行，定义为步行引起的步态功能障碍和肌肉疼痛，是 最常见的PAD表现。跛行影响5%的55岁以上的美国人。 跛行患者的活动能力下降，身体功能下降，健康状况不佳， 增加了福尔斯跌倒的风险。为了调查PAD患者的活动问题，本研究的PI Myers博士 研究项目，通过测量量（标准差和 变异系数）和时间结构（最大李雅普诺夫指数，样本熵 在步行过程中存在的波动或简单地称为步态变异性。这些措施正在出现， 研究临床步态障碍的重要研究工具，因为它们是福尔斯的预测因子， 个人适应运动环境的能力。迈尔斯医生的研究表明 与年龄匹配的健康对照组相比，PAD患者的步态变异性发生了改变。因此，本研究 该项目将利用步态变异性来确定常见PAD相关病理的影响， 确定步态变异性是否可以预测临床疾病参数（血流动力学、步行距离、质量 在基线和手术血运重建后。中心假设是步态变异性是 指示下肢健康结果，并可指导临床决策。步态可变性可以 确定PAD相关病理（糖尿病和不愈合、浅溃疡）对下 患者的肢体功能。确定哪种步态变异性参数是临床症状的最佳预测因子 疾病参数和下肢功能的改善手术后血运重建将 显著改变了治疗决策的方式。步态变异性可能会给医生 指导治疗决策的客观方法。总的来说，这项工作进展治疗实践， 确保只有能显著受益的患者才能接受侵入性外科手术。

PAD is a manifestation of systemic atherosclerosis, characterized by atherosclerotic blockages ofthe arteries supplying the legs. Claudication, defined as walking induced gait dysfunction and muscle pain, is the most common manifestation of PAD. Claudication affects 5% of Americans older than 55 years of age. Claudicating patients experience reduced mobility, reduced physical functioning, poor health outcomes, and increased risk for falls. To investigate the mobility issues in patients with PAD, Dr. Myers, the PI of this research project, has assessed lower extremity function by measuring amount (standard deviation and coefficient of variation) and temporal structure (largest Lyapunov exponent, sample entropy) of the stride-tostride fluctuations that exist during walking or simply termed gait variability. Such measures are emerging as important investigative tools to study clinical gait disorders, as they are predictors of falls and reflect individuals' capabilities to adapt within the movement environment. Dr. Myers' studies show that patients with PAD have altered gait variability as compared with healthy age-matched controls. Thus, this research project will utilize gait variability to determine the impact of common PAD related pathologies as well as determine if gait variability can predict clinical disease parameters (hemodynamics, walking distance, quality of life) at baseline and following surgical revascularization. The central hypothesis is that gait variability is indicative of lower extremity health outcomes and could guide clinical decision-making. Gait variability can establish the impact of PAD-related pathologies (diabetes and non-healing, shallow ulcers) on lower extremity function in patients. Determining which gait variability parameter is the best predictor of clinical disease parameters and of lower extremity function improvements post-surgical revascularization would significantly change how treatment decisions are being made. Gait variability potentially gives physicians an objective method to guide treatment decisions. Collectively, this work progresses treatment practice to ensure only patients who will significantly benefit will undergo invasive surgical procedures.