Gardner Andrew W, Montgomery Polly S, Killewich Lois A
Department of Health and Sport Sciences, University of Oklahoma, Norman 73019, USA.
J Vasc Surg. 2004 Jul;40(1):73-8. doi: 10.1016/j.jvs.2004.02.010.
This study was undertaken to determine the natural history of physical function in older men limited by intermittent claudication.
Forty-three men limited by intermittent claudication (mean age, 69 +/- 7 years) were recruited and followed up for 18 months. At baseline the patients reported a history of intermittent claudication for 6.1 +/- 6.1 years, and were able to walk for 1.9 +/- 1.6 blocks before experiencing claudication pain. Measurements during the 18-month study included ankle-brachial index (ABI), calf blood flow, 6-minute walk performance, monitored and self-reported physical activity, self-reported stability while walking, and summary performance score of physical function determined from a 4-m walk test, a chair stand test, and a tandem stand test.
Pain-free walking distance during the 6-minute walk test decreased by 22% (P <.05) from baseline (185 +/- 96 m) to follow-up (144 +/- 93 m), and the total 6-minute walk distance decreased by 9% (P <.05), from 368 +/- 106 m to 334 +/- 90 m. Furthermore, monitored physical activity decreased by 31% (P <.05), from 159 +/- 151 kcal/d to 110 +/- 137 kcal/d; self-reported physical activity declined by 27% (P <.05), from 1.5 +/- 1.0 units to 1.1 +/- 0.8 units; tandem stance time declined by 14% (P <.05), from 9.46 +/- 1.83 seconds to 8.12 +/- 2.10 seconds; summary performance score of physical function decreased by 12% (P <.05), from 6.8 +/- 2.4 units to 6.0 +/- 2.4 units; and the percentage of patients reporting ambulatory unsteadiness and stumbling increased from 28% to 43% (P <.05). Calf blood flow measured at rest declined by 18% (P <.05), from 3.72 +/- 1.81 (mL/100 mL(-1)/min(-1)) to 3.04 +/- 1.43 mL/100 mL(-1)/min(-1), whereas ABI did not change (P >.05).
Older men limited by intermittent claudication experienced decline in ambulatory function, physical activity, physical function, stability, and calf blood flow over 18 months of follow-up, despite no change in ABI.
本研究旨在确定受间歇性跛行限制的老年男性身体功能的自然史。
招募了43名受间歇性跛行限制的男性（平均年龄69±7岁），并对其进行了18个月的随访。基线时，患者报告间歇性跛行病史为6.1±6.1年，在出现跛行疼痛前能够行走1.9±1.6个街区。在18个月的研究期间进行的测量包括踝臂指数（ABI）、小腿血流量、6分钟步行表现、监测和自我报告的身体活动、自我报告的行走稳定性，以及根据4米步行测试、椅子站立测试和串联站立测试确定的身体功能综合表现评分。
6分钟步行测试中的无痛步行距离从基线时的（185±96米）降至随访时的（144±93米），下降了22%（P<.05），6分钟步行总距离从368±106米降至334±90米，下降了9%（P<.05）。此外，监测到的身体活动从159±151千卡/天降至110±137千卡/天，下降了31%（P<.05）；自我报告的身体活动从1.5±1.0单位降至1.1±0.8单位，下降了27%（P<.05）；串联站立时间从9.46±1.83秒降至8.12±2.10秒，下降了14%（P<.05）；身体功能综合表现评分从6.8±2.4单位降至6.0±2.4单位，下降了12%（P<.05）；报告行走不稳和绊倒的患者百分比从28%增加到43%（P<.05）。静息时测量的小腿血流量从3.72±1.81（毫升/100毫升⁻¹/分钟⁻¹）降至3.04±1.43毫升/100毫升⁻¹/分钟⁻¹，下降了18%（P<.05），而ABI没有变化（P>.05）。
受间歇性跛行限制的老年男性在18个月的随访中，尽管ABI没有变化，但行走功能、身体活动、身体功能、稳定性和小腿血流量均出现下降。
