CMRI Diabetes and Metabolic Research Program, Harold Hamm Oklahoma Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA.
Vasc Med. 2010 Feb;15(1):21-6. doi: 10.1177/1358863X09106836. Epub 2009 Sep 25.
We determined the effect of claudication pain on temporal and spatial gait characteristics, and on ambulatory symmetry at preferred and rapid self-selected walking paces in patients with unilateral peripheral arterial disease (PAD). Twenty-eight patients with PAD limited by intermittent claudication were studied. Patients ambulated at their preferred and rapid paces over a 7.3-meter portable gait mat system while they were pain-free and after experiencing claudication pain. The order of the pain-free and painful walking trials was randomized, and the following gait parameters were obtained: velocity, cadence, stride length, swing time, stance time, single-support time, and double-support time. During the self-selected rapid pace, patients walked 3% slower (p = 0.020) while in pain due to a 3% shorter stride length (p < 0.001), and they were in double-stance longer (p = 0.024). Claudication pain in the symptomatic leg resulted in an increase in single-stance (p = 0.007). Furthermore, gait became asymmetrical with pain, as the symptomatic leg spent a higher percentage of the gait cycle in the swing phase (p < 0.01) and lower percentages in stance (p < 0.01) and single-stance (p < 0.01) than the asymptomatic leg. Ambulation was symmetrical for all measures during the pain-free trial. In conclusion, claudication pain slows ambulatory velocity at preferred and rapid paces, and increases asymmetry when ambulatory function is challenged with rapid walking. The reduced ambulatory speed with the development of claudication pain may be an adaptation to elicit a safer and less destabilizing gait pattern.
我们旨在确定跛行疼痛对单侧外周动脉疾病（PAD）患者时空步态特征以及在自主选择的舒适和快速步行速度下的动态对称性的影响。本研究共纳入 28 例以间歇性跛行为主要症状的 PAD 患者。患者在无痛和跛行疼痛时分别在 7.3 米的便携式步态垫系统上以舒适和快速速度进行步行。无痛和跛行时的步行试验顺序是随机的，并且获取以下步态参数：速度、步频、步长、摆动时间、支撑时间、单支撑时间和双支撑时间。在自主选择的快速步行时，由于跛行导致步长缩短 3%（p<0.001），患者的速度降低了 3%（p=0.020），并且双支撑时间延长（p=0.024）。跛行时，患侧单支撑时间增加（p=0.007）。此外，由于跛行，步态变得不对称，即患侧在摆动期的步态周期中所占的百分比增加（p<0.01），而在支撑期（p<0.01）和单支撑期（p<0.01）的百分比减少。在无痛步行试验中，所有指标的步态都是对称的。总之，跛行疼痛会降低舒适和快速步行时的步行速度，并且在快速步行挑战步行功能时会增加不对称性。随着跛行的发展，步行速度降低可能是一种适应机制，以产生更安全和更稳定的步态模式。
