title: Associations of calf skeletal muscle characteristics and peripheral nerve function with self-perceived physical functioning and walking ability in persons with peripheral artery disease.
abstract: We determined whether more adverse calf muscle characteristics and poorer peripheral nerve function were associated with impairments in self-perceived physical functioning and walking ability in persons with lower extremity peripheral artery disease (PAD). Participants included 462 persons with PAD; measures included the ankle-brachial index (ABI), medical history, electrophysiologic characteristics of nerves, and computed tomography of calf muscle. Self-perceived physical functioning and walking ability were assessed using the 36-Item Short Form Health Survey (SF-36) and the Walking Impairment Questionnaire (WIQ). Results were adjusted for age, sex, race, ABI, body mass index, comorbidities, and other confounders. Lower calf muscle area was associated with a poorer SF-36 physical function (PF) score (overall p-trend < 0.001, 33.76 PF score for the lowest quartile versus 59.74 for the highest, pairwise p < 0.001) and a poorer WIQ walking distance score (p-trend = 0.001, 29.71 WIQ score for the lowest quartile versus 48.43 for the highest, pairwise p < 0.001). Higher calf muscle percent fat was associated with a poorer SF-36 PF score (p-trend < 0.001, 53.76 PF score for the lowest quartile versus 40.28 for the highest, pairwise p = 0.009). Slower peroneal nerve conduction velocity was associated with a poorer WIQ speed score ( p-trend = 0.023, 30.49 WIQ score for the lowest quartile versus 40.48 for the highest, pairwise p = 0.031). In summary, adverse calf muscle characteristics and poorer peripheral nerve function are associated significantly and independently with impairments in self-perceived physical functioning and walking ability in PAD persons.
authors.affiliation: Department of Medicine, Northwestern University's Feinberg School of Medicine, Chicago, IL, USA. natalie-evans@md.northwestern.edu
authors.forename: Natalie S
authors.initials: NS
authors.lastname: Evans
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Lu
authors.initials: L
authors.lastname: Tian
authors.forename: Yihua
authors.initials: Y
authors.lastname: Liao
authors.forename: Mary M
authors.initials: MM
authors.lastname: McDermott
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D005080:Exercise Test; D005260:Female; D006304:Health Status; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D051346:Mobility Limitation; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology; D058729:Peripheral Arterial Disease / Q000503:physiopathology*; D010525:Peripheral Nerves / Q000503:physiopathology*; D010523:Peripheral Nervous System Diseases / Q000150:complications / Q000503:physiopathology*; D011446:Prospective Studies; D016138:Walking