Abstract : Previous reports suggest that the severity of peripheral arterial disease (PAD) measured by the ank
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Abstract : Previous reports suggest that the severity of peripheral arterial disease (PAD) measured by the ankle-brachial index (ABI) is not associated with the magnitude of walking impairment measured by treadmill testing. These prior studies have had small sample sizes and included only PAD participants with symptoms of intermittent claudication. We studied the association of the ABI with diverse measures of walking performance in a cross-sectional study of 156 participants with PAD with and without intermittent claudication symptoms. Outcomes included the Gardner-Skinner treadmill test 6-minute walk 4-meter walking velocity at usual and fastest pace and the walking impairment questionnaire (WIQ). Adjusting for age sex race comorbidities leg symptoms and other confounders lower ABI values were associated with shorter distance achieved in the 6-minute walk (ABI lt 0.50 286 meters ABI 0.50-0.70 316 meters ABI 0.71-0.95 355 meters p trend lt 0.001) shorter maximal treadmill walking time (ABI lt 0.50 6.0 minutes ABI 0.50-0.70 6.9 minutes ABI 0.71-0.95 8.3 minutes p trend = 0.009) and lower WIQ distance scores (p trend = 0.007) among PAD participants. The ABI was not associated significantly with walking velocity over 4 meters treadmill time to onset of leg symptoms or the WIQ speed or stair-climbing scores. In conclusion among 156 participants with PAD with and without intermittent claudication lower ABI values are associated significantly with poorer walking endurance assessed by three distinct measures. Clinical Trial Registration - URL http//www.clinicaltrials.gov. Unique identifier NCT00106327.
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