title: Alterations in gait parameters with peripheral artery disease: The importance of pre-frailty as a confounding variable.
abstract: Although poor walking is the most common symptom of peripheral artery disease (PAD), reported results are inconsistent when comparing gait parameters between PAD patients and healthy controls. This inconsistency may be due to frailty, which is highly prevalent among PAD patients. To address this hypothesis, 41 participants, 17 PAD (74±8 years) and 24 aged-matched controls (76±7 years), were recruited. Gait was objectively assessed using validated wearable sensors. Analysis of covariate (ANCOVA) tests were used to compare gait parameters between PAD and non-PAD groups, considering age, gender, and body mass index as covariates, while stratified based on frailty status. According to the Fried frailty index, 47% of PAD and 50% of control participants were non-frail and the rest were classified as pre-frail. Within non-frail participants, gait speed, body sway during walking, stride length, gait cycle time, double-support, knee range of motion, speed variability, mid-swing speed, and gait initiation were significantly different between PAD and control groups (effect size d = 0.75±0.43). In the pre-frail group, however, most of the gait differences were diminished except for gait initiation and gait variability. Results suggest that gait initiation is the most sensitive parameter for detecting gait impairment in PAD participants when compared to controls, regardless of frailty status (d = 1.30-1.41; p<0.050). The observed interaction effect between frailty and PAD on gait parameters confirms the importance of assessing functionality in addition to age to provide more consistency in detecting motor performance impairments due to PAD.
authors.affiliation: Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, University of Arizona, Tucson, AZ, USA.|Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA.
authors.forename: Nima
authors.initials: N
authors.lastname: Toosizadeh
authors.affiliation: Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Stocker
authors.affiliation: Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, University of Arizona, Tucson, AZ, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Thiede
authors.affiliation: Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, University of Arizona, Tucson, AZ, USA.|Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Mohler
authors.affiliation: Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, University of Arizona, Tucson, AZ, USA.|Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Mills
authors.affiliation: Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, University of Arizona, Tucson, AZ, USA bijan.najafi@bcm.edu.|Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA.|Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Bijan
authors.initials: B
authors.lastname: Najafi
mesh_terms: D061725:Accelerometry; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D016330:Frail Elderly; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D009043:Motor Activity; D010147:Pain Measurement; D058729:Peripheral Arterial Disease / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D016138:Walking; D000072797:Walking Speed
keywords: gait analysis; peripheral artery disease; pre-frailty