title: Isokinetic strength and endurance in proximal and distal muscles in patients with peripheral artery disease.
abstract: BACKGROUND
  The objective of this study was to analyze the muscle strength and endurance of the proximal and distal lower-extremity muscles in peripheral artery disease (PAD) patients.
  
  
  METHODS
  Twenty patients with bilateral PAD with symptoms of intermittent claudication and nine control subjects without PAD were included in the study, comprising 40 and 18 legs, respectively. All subjects performed an isokinetic muscle test to evaluate the muscle strength and endurance of the proximal (knee extension and knee flexion movements) and distal (plantar flexion and dorsiflexion movements) muscle groups in the lower extremity.
  
  
  RESULTS
  Compared with the control group, the PAD group presented lower muscle strength in knee flexion (-14.0%), dorsiflexion (-26.0%), and plantar flexion (-21.2%) movements (P < 0.05) but similar strength in knee extension movements (P > 0.05). The PAD patients presented a 13.5% lower knee flexion/extension strength ratio compared with the control subjects (P < 0.05), as well as lower muscle endurance in dorsiflexion (-28.1%) and plantar flexion (-17.0%) movements (P < 0.05). The muscle endurance in knee flexion and knee extension movements was similar between PAD patients and the control subjects (P > 0.05).
  
  
  CONCLUSIONS
  PAD patients present lower proximal and distal muscle strength and lower distal muscle endurance than control patients. Therefore, interventions to improve muscle strength and endurance should be prescribed for PAD patients.
authors.affiliation: Hospital das Clínicas of the School of Medicine of the University of São Paulo, University of São Paulo, São Paulo, Brazil.
authors.forename: Lucas Caseri
authors.initials: LC
authors.lastname: Câmara
authors.forename: Raphael Mendes
authors.initials: RM
authors.lastname: Ritti-Dias
authors.forename: Annelise Lins
authors.initials: AL
authors.lastname: Menêses
authors.forename: Júlia Maria
authors.initials: JM
authors.lastname: D'Andréa Greve
authors.forename: Wilson Jacob
authors.initials: WJ
authors.lastname: Filho
authors.forename: José Maria
authors.initials: JM
authors.lastname: Santarém
authors.forename: Cláudia Lúcia de Moraes
authors.initials: CL
authors.lastname: Forjaz
authors.forename: Pedro
authors.initials: P
authors.lastname: Puech-Leão
authors.forename: Nelson
authors.initials: N
authors.lastname: Wolosker
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007511:Ischemia / Q000503:physiopathology*; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000503:physiopathology*; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000503:physiopathology*; D010807:Physical Endurance; D011237:Predictive Value of Tests; D018608:Ultrasonography, Doppler