Gardner Andrew W, Montgomery Polly S, Scott Kristy J, Blevins Steve M, Afaq Azhar, Nael Raha
CMRI Metabolic Research Program, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA.
J Vasc Surg. 2008 Nov;48(5):1238-44. doi: 10.1016/j.jvs.2008.06.062. Epub 2008 Sep 4.
To determine the association between daily ambulatory activity patterns and exercise performance in patients with intermittent claudication.
One hundred thirty-three patients limited by intermittent claudication participated in this study. Patients were assessed on their ambulatory activity patterns for 1 week with a small, lightweight step activity monitor attached to the ankle using elastic velcro straps above the lateral malleolus of the right leg. The step activity monitor recorded the number of strides taken on a minute-to-minute basis and the time spent ambulating. Patients also were characterized on ankle-brachial index (ABI), ischemic window (IW) after a treadmill test, as well as initial claudication distance (ICD), and absolute claudication distance (ACD) during treadmill exercise.
The patient characteristics (mean +/- SD) were as follows: ABI = 0.71 +/- 0.23, IW = 0.54 +/- 0.72 mm Hg.min.meter(-1), ICD = 236 +/- 198 meters, and ACD = 424 +/- 285 meters. The patients took 3366 +/- 1694 strides/day, and were active for 272 +/- 103 min/day. The cadence for the 30 highest, consecutive minutes of each day (15.1 +/- 7.2 strides/min) was correlated with ICD (r = 0.316, P < .001) and ACD (r = 0.471, P < 0.001), and the cadence for the 60 highest, consecutive minutes of each day (11.1 +/- 5.4 strides/min) was correlated with ICD (r = 0.290, P < .01) and ACD (r = 0.453, P < .001). Similarly, the cadences for the highest 1, 5, and 20 consecutive minutes, and the cadence for the 30 highest, nonconsecutive minutes all were correlated with ICD and ACD (P < .05). None of the ambulatory cadences were correlated with ABI (P > .05) or with ischemic window (P > .05).
Daily ambulatory cadences are associated with severity of intermittent claudication, as measured by ACD and ICD, but not with peripheral hemodynamic measures.
确定间歇性跛行患者日常活动模式与运动表现之间的关联。
133例受间歇性跛行限制的患者参与了本研究。使用弹性尼龙搭扣带将一个小型、轻便的步数活动监测器固定在右下肢外踝上方的脚踝处,对患者的日常活动模式进行为期1周的评估。步数活动监测器记录每分钟的步数以及行走时间。患者还通过踝臂指数(ABI)、跑步机测试后的缺血窗口(IW)以及跑步机运动期间的初始跛行距离(ICD)和绝对跛行距离(ACD)进行特征描述。
患者特征(均值±标准差)如下:ABI = 0.71±0.23,IW = 0.54±0.72 mmHg·min·m⁻¹,ICD = 236±198米,ACD = 424±285米。患者每天行走3366±1694步,每天活动272±103分钟。每天连续30分钟最高步数的步频(15.1±7.2步/分钟)与ICD(r = 0.316,P <.001)和ACD(r = 0.471,P < 0.001)相关,每天连续60分钟最高步数的步频(11.1±5.4步/分钟)与ICD(r = 0.290,P <.01)和ACD(r = 0.453,P <.001)相关。同样,连续最高1、5和20分钟的步频以及30分钟最高非连续步数的步频均与ICD和ACD相关(P <.05)。所有日常步频均与ABI(P >.05)或缺血窗口(P >.05)无关。
通过ACD和ICD衡量,日常行走步频与间歇性跛行的严重程度相关,但与外周血流动力学指标无关。