The relationship between history of falling and physical function in subjects with peripheral arterial disease.
The purpose of this study was to determine whether peripheral arterial disease (PAD) subjects with a history of falling had more impaired physical function than their non-falling counterparts. A total of 120 PAD subjects (26%) who had fallen over the past year and 346 PAD subjects (74%) who had not fallen were evaluated. Additionally, subjects were characterized on physical function, consisting of balance, strength, ambulatory function, and monitored physical activity, as well as PAD-specific measures of ankle/brachial pressure index (ABPI) and treadmill claudication distances. Full-tandem stance time was 19% shorter (p < 0.001) in the fallers than in the non-fallers (7.2 +/- 0.3 vs 8.9 +/- 0.1 s; mean +/- SEM), and the self-reported ability to climb stairs was 36% lower (27 +/- 4 vs 42 +/- 2%). Furthermore, the fallers were 126% more likely (p < 0.001) to report ambulatory stumbling and unsteadiness, took 14% longer (p = 0.022) to perform five sequential sit-to-stand transfers using an armless chair, covered 16% shorter distance (p < 0.001) during a 6-min walk test, and were 25% less physically active than the non-fallers. The groups had similar ABPI and treadmill claudication distances (p < 0.05). A history of falling was independently related to the self-reported ability to climb stairs, the full-tandem stance time, self-reported ambulatory stumbling and unsteadiness, and daily physical activity (multiple R = 0.47, p < 0.001). In conclusion, impairments in multiple domains of physical function were associated with a history of falling in PAD subjects with intermittent claudication. Furthermore, the link between poor physical function and falling was independent of PAD severity.
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Claude D Pepper Older Americans Independence Center, Department of Medicine, University of Maryland, Baltimore, USA. awgardner@ou.edu
Montgomery
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D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore / Q000453:epidemiology; D015444:Exercise / Q000502:physiology; D005080:Exercise Test; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000150:complications* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000503:physiopathology*; D012307:Risk Factors; D016138:Walking / Q000502:physiology