Myers Sara A, Johanning Jason M, Stergiou Nick, Lynch Thomas G, Longo G Matthew, Pipinos Iraklis I
Heath, Physical Education, and Recreation (HPER) Biomechanics Laboratory, University of Nebraska Medical Center, Omaha 68198-3280, USA.
J Vasc Surg. 2008 Mar;47(3):550-555. doi: 10.1016/j.jvs.2007.10.052. Epub 2008 Jan 22.
Claudication secondary to peripheral arterial disease leads to reduced mobility, limited physical functioning, and poor health outcomes. Disease severity can be assessed with quantitative clinical methods and qualitative self-perceived measures of quality of life. Limited data exist to document the degree to which quantitative and qualitative measures correlate. The current study provides data on the relationship between quantitative and qualitative measures of symptomatic peripheral arterial disease.
This descriptive case series was set in an academic vascular surgery unit and biomechanics laboratory. The subjects were symptomatic patients with peripheral arterial disease patients presenting with claudication. The quantitative evaluation outcome measures included measurement of ankle-brachial index, initial claudication distance, absolute claudication distance, and self-selected treadmill pace. Qualitative measurements included the Walking Impairment Questionnaire (WIQ) and the Medical Outcomes Study Short Form-36 (SF-36) Health Survey. Spearman rank correlations were performed to determine the relationship between each quantitative and qualitative measure and also between the WIQ and SF-36.
Included were 48 patients (age, 62 +/- 9.6 years; weight, 83.0 +/- 15.4 kg) with claudication (ABI, 0.50 +/- 0.20). Of the four WIQ subscales, the ankle-brachial index correlated with distance (r = 0.29) and speed (r = 0.32); and initial claudication distance and absolute claudication distance correlated with pain (r = 0.40 and 0.43, respectively), distance (r = 0.35 and 0.41, respectively), and speed (r = 0.39 and 0.39 respectively). Of the eight SF-36 subscales, no correlation was found for the ankle-brachial index, initial claudication distance correlated with Bodily Pain (r = 0.46) and Social Functioning (r = 0.30), and absolute claudication time correlated with Physical Function (r = 0.31) and Energy (r = 0.30). The results of both questionnaires showed reduced functional status in claudicating patients.
Initial and absolute claudication distances and WIQ pain, speed, and distance subscales are the measures that correlated the best with the ambulatory limitation of patients with symptomatic peripheral arterial disease. These results suggest the WIQ is the most specific questionnaire for documenting the qualitative deficits of the patient with claudication while providing strong relationships with the quantitative measures of arterial disease. Future studies of claudication patients should include both quantitative and qualitative assessments to adequately assess disease severity and functional status in peripheral arterial disease patients.
外周动脉疾病继发的间歇性跛行导致活动能力下降、身体功能受限及健康状况不佳。疾病严重程度可通过定量临床方法和生活质量的定性自我感知测量来评估。关于定量和定性测量之间的关联程度，现有数据有限。本研究提供了有症状外周动脉疾病的定量和定性测量之间关系的数据。
本描述性病例系列研究在一个学术性血管外科病房和生物力学实验室进行。研究对象为有间歇性跛行症状的外周动脉疾病患者。定量评估结果指标包括踝臂指数测量、初始跛行距离、绝对跛行距离和自行选择的跑步机速度。定性测量包括步行障碍问卷（WIQ）和医学结局研究简表36（SF - 36）健康调查。采用Spearman等级相关分析来确定各定量和定性测量之间以及WIQ和SF - 36之间的关系。
纳入48例患者（年龄62±9.6岁；体重83.0±15.4 kg），有间歇性跛行（踝臂指数0.50±0.）。在WIQ的四个分量表中，踝臂指数与距离（r = 0.29）和速度（r = 0.32）相关；初始跛行距离和绝对跛行距离与疼痛（分别为r = 0.40和0.43）、距离（分别为r = 0.35和0.41）以及速度（分别为r = 0.39和0.39）相关。在SF - 36的八个分量表中，踝臂指数未发现相关性，初始跛行距离与身体疼痛（r = 0.46）和社会功能（r = 0.30）相关，绝对跛行时间与身体功能（r = 0.31）和精力（r = 0.30）相关。两份问卷的结果均显示跛行患者的功能状态下降。
初始和绝对跛行距离以及WIQ的疼痛、速度和距离分量表是与有症状外周动脉疾病患者的行走受限相关性最佳的测量指标。这些结果表明，WIQ是记录跛行患者定性缺陷的最具特异性的问卷，同时与动脉疾病的定量测量有很强的相关性。未来关于跛行患者的研究应同时包括定量和定性评估，以充分评估外周动脉疾病患者的疾病严重程度和功能状态。
