Gait kinematics and kinetics are affected more by peripheral arterial disease than by age

Myers, Sara A.; Applequist, Bryon C.; Huisinga, Jessie M.; Pipinos, Iraklis I.; Johanning, Jason M.

doi:10.1682/jrrd.2015.02.0027

Cited by 21 publications

(26 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, age-related changes in neuromuscular activation can also be present during walking 35 . However, a recent study found that PAD impacts gait parameters more than age 36 and our results are consistent with the current literature on PAD. Consequently, we assume that our results stem mainly from PAD and not age.…”

Section: Discussionsupporting

confidence: 93%

Location of ischemia and ischemic pain intensity affect spatiotemporal parameters and leg muscles activity during walking in patients with intermittent claudication

Guilleron

Ábrahám

Beaune

et al. 2021

Sci Rep

View full text Add to dashboard Cite

The ways in which locations of ischemia and ischemic pain affect spatiotemporal gait parameters and leg electromyographic activity during walking have never been investigated in patients with peripheral arterial disease presenting intermittent claudication. Two groups were classified according to unilateral location of ischemia (distal, n = 10, or proximo-distal, n = 12). Patients described pain and three gait phases—initial pain-free, onset of pain and maximum pain—were analyzed. Patients with proximo-distal ischemia walked less (230 ± 111 m vs 384 ± 220 m), with increased step length, step time (+ 5.4% and + 5.8%) and reduced cadence (− 8.2%), than patients with distal ischemia. In both, the peaks of vertical ground reaction force were reduced in maximum pain (Peak1-distal: − 11.4%, Peak1-proximo-distal: − 10.3%; Peak2-distal: − 11.8%, Peak2-proximo-distal: − 9.0%). In the proximo-distal group, tibialis anterior activation peak and time were lower than in the distal group (− 4.5% and − 19.7%). During the maximum pain phase, this peak decreased only in the proximo-distal group (− 13.0%), and gastrocnemius medialis activation peak and time decreased in both groups (− 2.5% in distal and − 4.5% in proximo-distal). Thus, proximo-distal ischemia leads to more adverse consequences in gait than distal ischemia only. Increasing ischemic pain until maximum, but not onset of pain, induced gait adaptations.

show abstract

Section: Discussionsupporting

confidence: 93%

Location of ischemia and ischemic pain intensity affect spatiotemporal parameters and leg muscles activity during walking in patients with intermittent claudication

Guilleron

Ábrahám

Beaune

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…A/Impaired muscle strength and function Peripheral arterial disease pathophysiology is characterized by metabolic and structural myopathic changes in skeletal muscles, responsible for the decline in strength and function. 27 Lower extremity ischemia was shown to specifically impair proximal and distal leg muscles. Indeed, in a study of 424 patients with PAD, plantar flexion and knee extension strength was significantly lower when compared with age-matched controls.…”

Section: Resultsmentioning

confidence: 99%

Sarcopenia and peripheral arterial disease: a systematic review

Pizzimenti

Meyer

Charles

et al. 2020

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

Background Patients with lower extremity peripheral arterial disease (PAD) and sarcopenia are a population at risk requiring specific and targeted care. The aim of this review is to gather all relevant studies associating sarcopenia and PAD and to identify the underlying pathophysiological mechanisms as well as potential therapeutic strategies to improve skeletal muscle function. Methods A systematic review was carried out following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results Data extraction allowed the evaluation of 140 publications; 87 met the inclusion criteria; of which 79 were included in the final review, reporting sufficient data for epidemiological and diagnostic criteria, mechanical analysis, and therapeutic approaches. Epidemiological analysis and diagnostic criteria were based on 18 studies following 2362 PAD patients [31.39% (SD 7.61) women], aged 72.42 (SD 2.84); sarcopenia was present in 34.63% (SD 12.86) of the patients. Mechanical and pathway analysis were based on five animal studies and 29 clinical reports, showing significantly altered muscle strength and function in 1352 PAD patients [26.49% (SD 17.32) women], aged 67.67 (SD 5.14) years; impaired muscle histology in 192 PAD patients (9.2% (SD 11.22) women), aged 64.3 (SD 0.99) years; +58.63% (SD 25.48) of oxidative stress in 69 PAD patients [16.96% (SD 8.10) women], aged 63.17 (SD 1.43) years; mitochondriopathy in 153 PAD patients [29.39% (SD 28.27) women], aged 63.50 (SD 1.83) years; +15.58% (SD 7.41) of inflammation in 900 PAD patients [40.77% (SD 3.71) women], aged 74.88 (SD 2.76) years; and altered signalling pathways in 51 PAD patients [34.45% (SD 32.23) women], aged 72.25 (SD 5.25) years. Therapeutic approaches analysis was based on seven animal studies and 21 clinical reports. In total, 884 patients followed an exercise therapy, and 18 received an angiogenesis treatment; 30.84% (SD 17.74) were women. Mean ages of patients studied were 66.85 (SD 3.96). Conclusions Sarcopenia and lower extremity PAD have musculoskeletal consequences that directly impair patients' quality of life and prognosis. Although PAD is primarily a vascular disease, all etiological factors of sarcopenia identified so far are present in PAD. Indeed, both sarcopenia and PAD are accompanied by oxidative stress, skeletal muscle mitochondrial impairments, inflammation, inhibition of specific pathways regulating muscle synthesis or protection (i.e. IGF-1, RISK, and SAFE), and activation of molecules associated with muscle degradation. To date, besides revascularization, the best therapeutic strategy includes exercise, but approaches targeting the underlying mechanisms still deserve further studies.

show abstract

“…Gommans et al [3] did not find a significant increase in EMG amplitude for the medial gastrocnemius and tibialis anterior muscles during walking in patients with IC compared to healthy people. To date, the majority of studies on the gait of patients with IC have reported that kinematic and kinetic variables are significantly altered in patients during pain-free walking [3, 6, 10, 11, 15–19, 28, 32]. This difference compared to our study is likely to be caused by the use of different measurement methods (such as Gardner Treadmill Test, 6-Minute Walk Test, different walking distance) and devices (such as portable walkway system, isokinetic dynamometer, digital video cameras not infrared, other motion capture systems with a different number of cameras, other force plates with different sampling frequency, and different number of force plates).…”

Section: Discussionmentioning

confidence: 99%

“…It has been demonstrated that gait velocity has significant impacts on the kinematic and kinetic gait patterns [1, 26, 27]. Other variables such as age only indirectly differentiate gait because their relationship with gait variables results from differences in the gait velocity of the examined person [28]. In particular, kinematic angular variables characterizing the knee and ankle joints are positively correlated with gait velocity [29, 30].…”

Section: Methodsmentioning

confidence: 99%

Changes in Gait Variables in Patients with Intermittent Claudication

Pietraszewski

Woźniewski

Jasiński

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

Objective. Intermittent claudication (IC) is a pathological symptom with a particular effect on human gait patterns. Therefore, analyzing these patterns can facilitate rehabilitation or treatment through comparison of the values of kinematic and kinetic variables of patients with the normal values of healthy people. Therefore, the aim of this study was to find differences in the values of gait variables between patients with IC and healthy people. Methods. The study included 98 patients diagnosed with peripheral arterial disease with IC. The patients traveled a distance of 6 m at a voluntary gait velocity. Ground reaction forces while the foot contacted the ground and kinematic variables of lower limb movements were recorded. The values of normal gait variables were computed based on the results obtained in a group of 30 healthy people. Results. Patients used a gait velocity below the norm for healthy people. The velocity during the lower limb swing and the step and stride length in patients with IC were below the norm. Differences were also found in the ranges of motion between patients with IC and healthy people for the pelvic obliquity, pelvic rotation, hip flexion-extension, hip abduction-adduction, hip internal-external rotation, knee flexion-extension, ankle dorsi-plantar flexion, and foot progression angles. Conclusions. The presented kinematic and kinetic characteristics measured by gait variables suggest differences between patients with IC and healthy people. Considering kinematic and kinetic gait variables during the rehabilitation process would facilitate the development of a more economic gait technique (with increased stride length and range of motion in the lower limb joints) to obtain the desired rehabilitation effects. Patients with IC should receive rehabilitation oriented towards improving mobility and increasing muscle strength in selected lower limb joints to increase gait velocity and stride length.

show abstract

Gait kinematics and kinetics are affected more by peripheral arterial disease than by age

Cited by 21 publications

References 37 publications

Location of ischemia and ischemic pain intensity affect spatiotemporal parameters and leg muscles activity during walking in patients with intermittent claudication

Location of ischemia and ischemic pain intensity affect spatiotemporal parameters and leg muscles activity during walking in patients with intermittent claudication

Sarcopenia and peripheral arterial disease: a systematic review

Changes in Gait Variables in Patients with Intermittent Claudication

Contact Info

Product

Resources

About