Physical Function Predictors in PAD and Claudication Patients
Physical Function Predictors in PAD and Claudication Patients
Limitation of walking due to claudication is the hallmark of peripheral arterial disease. The purpose of this secondary analysis was to identify biobehavioral predictors of physical function in peripheral arterial disease patients that included walking ability, gender, age, disease severity, environmental factors (social support), and medical comorbidity (arthritis). All subjects performed an exercise treadmill test to determine initial and absolute claudication distance. The sample consisted of 97 peripheral arterial disease patients, 71 (73%) men and 26 (27%) women, with a mean age of 73±8 years (range 52-90 years). Initial claudication distance occurred at 171.88±136.35 m. Absolute claudication distance was 421.03±286.37 m. A simultaneous multiple regression analysis was performed to determine predictors of physical function. The model accounted for 35% of the variance (p < 0.001) and included personal characteristics (age, gender, years of education), severity of disease by ankle-brachial index, environmental factors of social support (marital status), absolute claudication distance, and arthritis. Education ( p =0.011), absolute claudication distance (p = 0.014), social support (p = 0.026), arthritis (p = 0.028), and age (p = 0.033) were the strongest predictors of physical function. This study identifies biobehavioral factors that place peripheral arterial disease patients at greater risk for reduced physical function and provides a rationale for interventions that improve walking ability.
The hallmark of peripheral arterial disease (PAD) is walking impairment due to claudication. Claudication results from significant and diffuse atherosclerosis. Limitations in walking ability lead to deconditioning that precipitates a chain of events resulting in further functional decline, eventual physical disability, loss of independence, and finally impaired quality of life. While limitations in walking ability have been described, their impact on physical function have not been fully explored. Therefore, to develop effective strategies that prevent physical disability and improve quality of life in PAD patients, a better understanding of the determinants of physical function is needed.
To date, most studies have examined the relationship between disease severity and physical function or the efficacy of pharmacologic or surgical treatments on quality of life. Few studies have examined biobehavioral determinants of physical function. Studies in the elderly and PAD patients suggest that physical function is influenced not only by exercise capacity, but also by other factors that include gender; age; disease severity; and environmental factors such as socioeconomic status, social support, and symptoms. The purpose of this investigation was to identify biobehavioral predictors of physical function in men and women with PAD and claudication.
Limitation of walking due to claudication is the hallmark of peripheral arterial disease. The purpose of this secondary analysis was to identify biobehavioral predictors of physical function in peripheral arterial disease patients that included walking ability, gender, age, disease severity, environmental factors (social support), and medical comorbidity (arthritis). All subjects performed an exercise treadmill test to determine initial and absolute claudication distance. The sample consisted of 97 peripheral arterial disease patients, 71 (73%) men and 26 (27%) women, with a mean age of 73±8 years (range 52-90 years). Initial claudication distance occurred at 171.88±136.35 m. Absolute claudication distance was 421.03±286.37 m. A simultaneous multiple regression analysis was performed to determine predictors of physical function. The model accounted for 35% of the variance (p < 0.001) and included personal characteristics (age, gender, years of education), severity of disease by ankle-brachial index, environmental factors of social support (marital status), absolute claudication distance, and arthritis. Education ( p =0.011), absolute claudication distance (p = 0.014), social support (p = 0.026), arthritis (p = 0.028), and age (p = 0.033) were the strongest predictors of physical function. This study identifies biobehavioral factors that place peripheral arterial disease patients at greater risk for reduced physical function and provides a rationale for interventions that improve walking ability.
The hallmark of peripheral arterial disease (PAD) is walking impairment due to claudication. Claudication results from significant and diffuse atherosclerosis. Limitations in walking ability lead to deconditioning that precipitates a chain of events resulting in further functional decline, eventual physical disability, loss of independence, and finally impaired quality of life. While limitations in walking ability have been described, their impact on physical function have not been fully explored. Therefore, to develop effective strategies that prevent physical disability and improve quality of life in PAD patients, a better understanding of the determinants of physical function is needed.
To date, most studies have examined the relationship between disease severity and physical function or the efficacy of pharmacologic or surgical treatments on quality of life. Few studies have examined biobehavioral determinants of physical function. Studies in the elderly and PAD patients suggest that physical function is influenced not only by exercise capacity, but also by other factors that include gender; age; disease severity; and environmental factors such as socioeconomic status, social support, and symptoms. The purpose of this investigation was to identify biobehavioral predictors of physical function in men and women with PAD and claudication.
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