title: Global positioning system use in the community to evaluate improvements in walking after revascularization: a prospective multicenter study with 6-month follow-up in patients with peripheral arterial disease.
abstract: Revascularization aims at improving walking ability in patients with arterial claudication. The highest measured distance between 2 stops (highest-MDCW), the average walking speed (average-WSCW), and the average stop duration (average-DSCW) can be measured by global positioning system, but their evolution after revascularization is unknown.We included 251 peripheral artery diseased patients with self-reported limiting claudication. The patients performed a 1-hour stroll, recorded by a global positioning system receiver. Patients (n = 172) with confirmed limitation (highest-MDCW <2000m) at inclusion were reevaluated after 6 months. Patients revascularized during the follow-up period were compared with reference patients (ie, with unchanged lifestyle medical or surgical status). Other patients (lost to follow-up or treatment change) were excluded (n = 89).We studied 44 revascularized and 39 reference patients. Changes in highest-MDCW (+442 vs. +13 m) and average-WSCW (+0.3 vs. -0.2 km h) were greater in revascularized than in reference patients (both P < 0.01). In contrast, no significant difference in average-DSCW changes was found between the groups. Among the revascularized patients, 13 (29.5%) had a change in average-WSCW, but not in highest-MDCW, greater than the mean + 1 standard deviation of the change observed for reference patients.Revascularization may improve highest-MDCW and/or average-WSCW. This first report of changes in community walking ability in revascularized patients suggests that, beyond measuring walking distances, average-WSCW measurement is essential to monitor these changes. Applicability to other surgical populations remains to be evaluated.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov/ct2/show/NCT01141361.
authors.affiliation: From the Laboratory for Vascular Investigations. University Hospital (MG, PA); Laboratory of Physiology, CNRS, UMR6214; Inserm, U771; Medical School, University of Angers (MG, BN-D, PA); Movement, Sport and Health laboratory (M2S). EA 1274. UFR APS, University of Rennes, Rennes (ALF); Ecole normale supérieure de Rennes, Rennes (ENS Rennes); Department of Sports Science and Physical Education, Bruz (ALF); INSERM, Clinical Investigation Center (CIC 1414), Rennes (ALF, GM); Centre Hospitalier, Le Mans (DF, BN-D); IFEPSA, Apcoss (BN-D); Centre Hospitalier Universitaire, Poitiers (CL); and University Hospital of Rennes, Rennes, France (GM).
authors.forename: Marie
authors.initials: M
authors.lastname: Gernigon
authors.forename: Alexis
authors.initials: A
authors.lastname: Le Faucheur
authors.forename: Dominique
authors.initials: D
authors.lastname: Fradin
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Noury-Desvaux
authors.forename: Cédric
authors.initials: C
authors.lastname: Landron
authors.forename: Guillaume
authors.initials: G
authors.lastname: Mahe
authors.forename: Pierre
authors.initials: P
authors.lastname: Abraham
mesh_terms: D000368:Aged; D017130:Angioplasty; D005260:Female; D005500:Follow-Up Studies; D040362:Geographic Information Systems; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*