Department of Vascular Surgery, Academic Medical Center, Amsterdam, The Netherlands.
J Vasc Surg. 2013 Mar;57(3):720-727.e1. doi: 10.1016/j.jvs.2012.09.044. Epub 2013 Jan 11.
Physicians and patients consider the limited walking distance and perceived disability when they make decisions regarding (invasive) treatment of intermittent claudication (IC). We investigated the relationship between walking distances estimated by the patient, on the corridor and on a treadmill, and the Walking Impairment Questionnaire (WIQ) in patients with IC due to peripheral arterial disease.
This was a single-center, prospective observational cohort study at a vascular laboratory in a university hospital in the Netherlands. The study consisted of 60 patients (41 male) with a median age of 64 years (range, 44-86 years) with IC and a walking distance ≤ 250 m on a standardized treadmill test. Main outcome measures were differences and Spearman rank correlations between pain-free walking distance, maximum walking distance (MWD) estimated by the patient, on the corridor and on a standardized treadmill test, and their correlation with the WIQ.
The median patients' estimated, corridor, and treadmill MWD were 200, 200, and 123, respectively (P < .05). Although the median patients' estimated and corridor MWD were not significantly different, there was a difference on an individual basis. The correlation between the patients' estimated and corridor MWD was moderate (r = 0.61; 95% confidence interval [CI], 0.42-0.75). The correlation between patients' estimated and treadmill MWD was weak (r = 0.39; 95%, CI 0.15-0.58). Respective correlations for the pain-free walking distance were comparable. The patients' estimated MWD was moderately correlated with WIQ total score (r = 0.63; 95%, CI 0.45-0.76) and strongly correlated with WIQ distance score (r = 0.81; 95% CI, 0.69-0.88). The correlation between the corridor MWD and WIQ distance score was moderate (r = 0.59; 95% CI, 0.40-0.74).
Patients' estimated walking distances and on a treadmill do not reflect walking distances in daily life. Instruments that take into account the perceived walking impairment, such as the WIQ, may help to better guide and evaluate treatment decisions.
医生和患者在决定间歇性跛行（IC）的（有创）治疗时，会考虑到有限的步行距离和感知到的残疾。我们研究了因外周动脉疾病导致 IC 的患者在走廊和跑步机上估计的步行距离与步行障碍问卷（WIQ）之间的关系。
这是一项在荷兰一所大学医院血管实验室进行的单中心前瞻性观察队列研究。该研究包括 60 名患者（41 名男性），中位年龄 64 岁（范围，44-86 岁），在标准化跑步机测试中步行距离≤250m。主要观察指标为无疼痛步行距离、患者估计的最大步行距离（MWD）、走廊和标准化跑步机测试的 MWD 之间的差异和 Spearman 秩相关，以及与 WIQ 的相关性。
患者估计的、走廊和跑步机的 MWD 中位数分别为 200、200 和 123（P<.05）。尽管患者估计的和走廊 MWD 中位数没有显著差异，但在个体基础上存在差异。患者估计的和走廊 MWD 之间的相关性为中度（r=0.61；95%置信区间[CI]，0.42-0.75）。患者估计的和跑步机 MWD 之间的相关性较弱（r=0.39；95%CI，0.15-0.58）。无疼痛步行距离的相关性相当。患者估计的 MWD 与 WIQ 总分中度相关（r=0.63；95%CI，0.45-0.76），与 WIQ 距离评分高度相关（r=0.81；95%CI，0.69-0.88）。走廊 MWD 与 WIQ 距离评分的相关性为中度（r=0.59；95%CI，0.40-0.74）。
患者估计的步行距离和在跑步机上的步行距离并不能反映日常生活中的步行距离。考虑到感知到的步行障碍的仪器，如 WIQ，可能有助于更好地指导和评估治疗决策。
