The effect of claudication pain on temporal and spatial gait measures during self-paced ambulation.
We determined the effect of claudication pain on temporal and spatial gait characteristics, and on ambulatory symmetry at preferred and rapid self-selected walking paces in patients with unilateral peripheral arterial disease (PAD). Twenty-eight patients with PAD limited by intermittent claudication were studied. Patients ambulated at their preferred and rapid paces over a 7.3-meter portable gait mat system while they were pain-free and after experiencing claudication pain. The order of the pain-free and painful walking trials was randomized, and the following gait parameters were obtained: velocity, cadence, stride length, swing time, stance time, single-support time, and double-support time. During the self-selected rapid pace, patients walked 3% slower (p = 0.020) while in pain due to a 3% shorter stride length (p < 0.001), and they were in double-stance longer (p = 0.024). Claudication pain in the symptomatic leg resulted in an increase in single-stance (p = 0.007). Furthermore, gait became asymmetrical with pain, as the symptomatic leg spent a higher percentage of the gait cycle in the swing phase (p < 0.01) and lower percentages in stance (p < 0.01) and single-stance (p < 0.01) than the asymptomatic leg. Ambulation was symmetrical for all measures during the pain-free trial. In conclusion, claudication pain slows ambulatory velocity at preferred and rapid paces, and increases asymmetry when ambulatory function is challenged with rapid walking. The reduced ambulatory speed with the development of claudication pain may be an adaptation to elicit a safer and less destabilizing gait pattern.
Gardner
Andrew W
AW
CMRI Diabetes and Metabolic Research Program, Harold Hamm Oklahoma Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA. andrew-gardner@ouhsc.edu
Montgomery
Polly S
PS
Ritti-Dias
Raphael M
RM
Forrester
Larry
L
D000203:Activities of Daily Living; D000222:Adaptation, Physiological; D000368:Aged; D001696:Biomechanical Phenomena; D005080:Exercise Test; D005260:Female; D005684:Gait; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000503:physiopathology*; D004856:Postural Balance; D013997:Time Factors; D016138:Walking