Gait alterations associated with walking impairment in people with peripheral arterial disease with and without intermittent claudication
Gait alterations associated with walking impairment in people with peripheral arterial disease with and without intermittent claudication
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DOI：
10.1046/j.1532-5415.2001.49151.x
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发表时间：
2001-06-01
影响因子：
6.3
通讯作者：
Greenland, P
中科院分区：
文献类型：
--
作者：
McDermott, MM;Ohlmiller, SM;Greenland, P
目的：描述与下肢外周动脉疾病（PAD）患者和非PAD患者步行耐力受损相关的步态改变，并确定Caltrac加速度计是否能有效测量PAD患者的身体活动。设计：横断面。设置：学术医学中心。参与者：来自芝加哥两家医院的PAD患者（n = 40）和非PAD患者（n = 22）。测量：参与者接受了踝臂指数（ABI），腿长和6分钟步行的测量。在6分钟步行的第一个和最后100英尺期间测量每分钟的步数和步长。参与者穿着Caltrac加速度计，敏感的垂直加速度，在6分钟的步行和7连续day.RESULTS：五PAD参与者（13%）和一个non-PAD参与者（5%）停止步行结束前6分钟。在剩下的参与者中，6分钟内步行的距离与最后100英尺的步行速度的相关性比前100英尺的步行速度更高。ABI与踏频显著相关（每单位ASI为20.77步/分钟，P <0.001），但与步长无关（每单位ABI为10.12厘米，P <0.08）。ABI与6分钟步行距离显著相关（493英尺/单位ABI，P = 0.018），但在调整步长和节奏后，这种相关性完全消失。我们发现在800英尺的固定距离内，PAD和非PAD参与者的加速度计评分没有差异（7.34 vs 7.17活动单位，P = 0.789）。然而，7天后评分有显著差异（730.8 vs 1，485.0活动单位，P = .003）。结论：完成6分钟步行的PAD患者的步行表现主要取决于步行速度的下降，而不是较慢的初始步行速度。ABI与步频的关系比步长更密切。未来的研究应评估运动计划和血管重建对PAD患者节奏和步长的影响。
OBJECTIVES: To describe gait alterations associated with impaired walking endurance in patients with and without lower-extremity peripheral arterial disease (PAD) and determine whether the Caltrac accelerometer provides a valid measure of physical activity in PAD.DESIGN: Cross-sectional.SETTING: Academic medical center.PARTICIPANTS: PAD (n = 40) and non-PAD patients (n = 22) from two Chicago hospitals.MEASUREMENTS: Participants underwent measurement of the ankle brachial index (ABI), leg length, and 6-minure walk. Steps per minute and step length were measured during the first and last 100 feet of the 6-minute walk. Participants wore a Caltrac accelerometer, sensitive to vertical acceleration, during the 6-minute walk and for 7 continuous days.RESULTS: Five PAD participants (13%) and one non-PAD participant (5%) ceased walking before the end of 6 minutes. Among the remaining participants, distance walked in 6 minutes was more highly related to walking velocity during the last 100 feet of the walk than walking velocity during the first 100 feet. ABI was associated significantly with cadence (20.77 steps/minute per unit ASI, P < .001) but not step length (10.12 centimeters/unit ABI, P < .08). ABI was associated significantly with 6-minute walk distance (493 feet/unit ABI, P = .018), but this association disappeared completely after adjustment for step length and cadence. We found no difference in accelerometer scores between PAD and non-PAD participants over a fixed distance of 800 feet (7.34 vs 7.17 activity units, P = .789). However, scores were significantly different after 7 days (730.8 vs 1,485.0 activity units, P = .003).CONCLUSION: Walking performance in PAD patients who completed 6 minutes of walking was largely determined by a decline in walking velocity rather than slower initial walking velocity. ABI was more closely associated with cadence than step length. Future studies should assess the effect of exercise programs and revascularization on cadence and step length in PAD.