Gait variability in patients with peripheral arterial disease

外周动脉疾病患者的步态变异

• 批准号: 9057584
• 负责人: Sara A Myers
• 金额: $ 19.58万
• 依托单位: UNIVERSITY OF NEBRASKA OMAHA
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9057584
• 关键词: Address; Affect; Age; Age-Years; American; Ankle; Arteries; Articular Range of Motion; Atherosclerosis; Blood Vessels; Brain; Characteristics; Clinic; Clinical; Collaborations; Comorbidity; Complex; Consensus; Data; Decision Making; Diabetes Mellitus; Diabetic ulcer; Disease; Ensure; Entropy; Environment; Evaluation; Foot Ulcer; Functional disorder; Funding; Gait; Gait abnormality; Goals; Health; Human; Impairment; Individual; Leg; Limb structure; Lower Extremity; Measures; Mentorship; Methods; Motor; Movement; Musculoskeletal System; Myalgia; Operative Surgical Procedures; Outcome; Pathology; Patient Care; Patients; Peripheral Nerves; Peripheral arterial disease; Physical Function; Physicians; Positioning Attribute; Principal Investigator; Quality of life; Questionnaires; Research; Research Project Grants; SF-36; Sampling; Senior Scientist; Severity of illness; Structure; Surgeon; System; Testing; Ulcer; United States National Institutes of Health; Variant; Visit; Walking; Work; claudication; clinical care; clinical decision-making; clinical predictors; design; experience; fall risk; falls; functional improvement; hemodynamics; improved; indexing; non-diabetic; prevent; response; tool

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.

PAD是系统性动脉粥样硬化的一种表现，其特征是动脉粥样硬化阻塞 供应腿部的动脉。跛行，定义为行走引起的步态障碍和肌肉疼痛，是 PAD最常见的表现形式。在55岁以上的美国人中，有5%的人患有跛行。 患者行动不便，身体功能下降，健康状况不佳，以及 摔倒的风险增加。为了调查PAD患者的活动能力问题，Myers博士，这位PI 研究项目，通过测量量(标准差和 (变异系数)和时间结构(最大Lyapunov指数、样本熵)。 行走过程中存在的波动或简单地称为步态可变性。这些措施正在出现，如 研究临床步态障碍的重要研究工具，因为它们是跌倒的预测因素和反映 个人在运动环境中的适应能力。迈尔斯博士的研究表明，患者 与年龄匹配的健康对照组相比，患有PAD的患者的步态可变性发生了改变。因此，本研究 该项目将利用步态可变性来确定与常见垫相关的病理以及 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 在基线和外科血管重建术后)。中心假设是步态可变性是 可预测患者的肢体健康状况，并可指导临床决策。步态变异性可能 建立与PAD相关的病理(糖尿病和无法愈合的浅表溃疡)对下腹部的影响 患者的肢体功能。确定哪个步态变异性参数是临床最好的预测因子 手术后血运重建后的疾病参数和下肢功能改善 极大地改变了治疗决策的方式。步态可变性可能会给医生带来 目的探讨指导治疗决策的方法。总体而言，这项工作将治疗实践推进到 确保只有将显著受益的患者才会接受侵入性外科手术。