title: Effect of premeasurement rest time on systolic ankle pressure.
abstract: BACKGROUND
  Systolic ankle pressures are routinely measured as part of an ankle-brachial index to screen for lower extremity peripheral arterial disease. Despite widespread use of this measurement, the effect of premeasurement duration of rest on the magnitude, or reliability of the ankle systolic pressure measurement is unknown. This study assessed the effect of premeasurement rest duration on systolic ankle pressures.
  
  
  RESULTS
  One hundred and forty participants meeting guidelines for peripheral arterial disease screening volunteered for this study. Following 5 minutes of rest in the supine horizontal position, ankle systolic pressures of the lower extremity were taken. Measurements were repeated at 10 and 15 minutes. Testing was repeated 7 to 10 days later. A significant drop in ankle pressure of 5.02 mm Hg occurred between 5 and 10 minutes (P=0.004). No significant change occurred between 10 and 15 minutes (mean change 0.15 mm Hg, P=0.99). Presence of diabetes was associated with a smaller drop between 5 and 15 minutes (mean change 1.85 mm Hg) and predicted 13.4% of the variance in change in ankle pressure (β=-3.61, P=0.0001). Test-retest reliability after 5 minutes was excellent (intraclass correlation coefficient: 0.84, 95% CI: 0.76 to 0.91) however increased for measurements taken at 10 and 15 minutes (intraclass correlation coefficient: 0.89 95% CI: 0.83 to 0.94 and 0.89 95% CI: 0.82 to 0.93).
  
  
  CONCLUSIONS
  Results suggest ankle systolic pressures stabilise after 10 minutes of rest. Longer periods of premeasurement rest did not improve reliability significantly. Though diabetes affects ankle pressure changes after rest, further investigation is required to identify the cause.
authors: School of Health Sciences, University of Newcastle, Australia.
authors: Vivienne H
authors: VH
authors: Chuter
authors: Sarah L
authors: SL
authors: Casey
mesh_terms: D000368:Aged; D000842:Ankle / Q000098:blood supply*; D055109:Ankle Brachial Index; D001794:Blood Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D056888:Patient Positioning; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012146:Rest; D016683:Supine Position; D013599:Systole; D013997:Time Factors
keywords: blood pressure; diabetes mellitus; peripheral arterial disease
references: J Am Coll Cardiol. 2011 Nov 1;58(19):2020-45
references: 21963765
references: J Clin Invest. 1981 Dec;68(6):1427-34
references: 7033283
references: Am J Hypertens. 2006 Jul;19(7):713-7
references: 16814126
references: Circulation. 2009 Nov 24;120(21):2053-61
references: 19901192
references: AIDS Res Hum Retroviruses. 2010 Sep;26(9):955-9
references: 20718628
references: Diabetologia. 1969 Jun;5(3):171-8
references: 5373816
references: Ann Vasc Surg. 2011 Aug;25(6):770-7
references: 21514102
references: Eur J Vasc Endovasc Surg. 2011 Jan;41(1):110-6
references: 21095144
references: Circulation. 2008 Aug 26;118(9):961-7
references: 18697822
references: Diabetologia. 1993 Jul;36(7):615-21
references: 8359578
references: JAMA. 2002 May 15;287(19):2570-81
references: 12020339
references: Vasc Med. 2010 Oct;15(5):361-9
references: 20926495
references: Circulation. 1985 Mar;71(3):510-5
references: 3156006
references: Hypertension. 2003 Dec;42(6):1206-52
references: 14656957
references: J Am Coll Cardiol. 2006 Mar 21;47(6):1239-312
references: 16545667
references: J Vasc Surg. 2007 Jan;45 Suppl S:S5-67
references: 17223489
references: Br J Pharmacol. 2000 Jul;130(5):963-74
references: 10882379
references: J Vasc Surg. 2001 May;33(5):1033-40
references: 11331846
references: BMJ. 1996 Dec 7;313(7070):1440-4
references: 8973232