title: Comparison of reported symptoms to those produced by treadmill testing in patients with claudication suspected of arterial origin.
abstract: OBJECTIVE
  We aimed at comparing lower limb symptoms reported by history to those observed during a standard treadmill test.
  
  
  METHODS
  We retrospectively studied symptomatic patients referred over a three years period for suspected arterial claudication and used the Edinburgh claudication questionnaire before exercise and symptoms observed on a treadmill. We confronted, right and left, proximal (lower-back thigh or buttocks) and distal (leg or foot) lower-limb symptoms before and during treadmill exercise. Results are reported as mean ± standard deviation for percentage and 95% confidence interval and Kappa statistics are performed.
  
  
  RESULTS
  Of 795 patients with claudication, aged 63 ± 12 years, treadmill test resulted in 715 reporting lower-limb symptoms on treadmill. Cohen's Kappa for the site-specific analysis of symptoms by history vs. symptoms on treadmill was 0.509 ± 0.21 (P < 0.01), showing a moderate agreement. Nevertheless, symptoms on treadmill reproduced, at least partly, symptoms by history in 675 (84.9% 95CI: 82.3-87.2) of patients, although symptoms on treadmill were strictly of the same localizations as symptoms by history in only 378 (47.6% 95CI: 44.1-51.0) of all studied patients. Last, 279 patients (35.1% of all patients) reported non limb symptoms on treadmill.
  
  
  CONCLUSIONS
  Although on a site by site basis the concordance of symptoms by history to symptoms by treadmill is moderate, most patients reproduced their usual symptoms on treadmill. Age does not seem to impair the concordance. Last, beyond the sole measurement of maximal walking capacity, treadmill frequently unmasks non-limb limiting symptoms that may require clinical attention.
authors: Université Angers, CHU Angers, Laboratory for Vascular Investigations. Angers Cedex 09, France - Piabraham@chu-angers.fr.
authors: G
authors: G
authors: Audat
authors: M
authors: M
authors: Harbonnier
authors: N
authors: N
authors: Ouedraogo
authors: G
authors: G
authors: Leftheriotis
authors: P
authors: P
authors: Abraham
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000503:physiopathology; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016138:Walking