Nantakool Sothida, Chuatrakoon Busaba, Sittichoke Cattaleeya, Konghakote Supatcha, Rerkasem Kittipan, Buranapin Supawan, Kanlayanee Sawat, Pothaya Natthaset, Kidarn Jitbergbarn
Neuro-Musculoskeletal, Chronic Disease, and Aging Research Engagement Center (I-CARE center), Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
Environmental-Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
Sci Prog. 2024 Oct-Dec;107(4):368504241305822. doi: 10.1177/00368504241305822.
Two walking tests including the six-minute walk test (6MWT) and the incremental shuttle walk test (ISWT) are widely used to evaluate functional ability in individuals with disease conditions. However, it remains unclear whether these walking tests effectively manifest clinical impairment in individuals with asymptomatic peripheral artery disease (PAD). We aimed (i) to compare the walking performance of individuals with and without asymptomatic PAD using the 6MWT and ISWT, and (ii) to investigate the correlation between ankle-brachial index and toe-brachial index (ABI-TBI) and the walking distance.
A cross-sectional, crossover, matched pairs design was employed in this study. Asymptomatic PAD was diagnosed using ABI-TBI measurements. Seventy-six participants (38 with asymptomatic PAD and 38 without PAD) were randomly ordered to perform the walking tests. During the 6MWT, participants walked along the 30-meter corridor at their self-selected pace for six minutes, and the six-minute walk distance (6MWD) covered was recorded. In the ISWT, participants walked at a 12 prescribed speed level, and the incremental shuttle walk distance (ISWD) covered was recorded.
Result revealed no difference in 6MWD between individuals with asymptomatic PAD and without PAD (mean distance: 501.6 m vs 516.8 m, p = 0.24). Asymptomatic PAD individuals exhibited a significantly shorter ISWD than those without PAD (median distance: 270 m vs 340 m, p = 0.003). No participants reported any leg pain symptoms during the 6MWT and ISWT. A statistically significant positive correlation was observed between the right leg TBI and ISWD in all participants (r = 0.23, p = 0.04).
Individuals with asymptomatic PAD demonstrated poorer walking performance than those without PAD when assessed using ISWT but not the 6MWT. Asymptomatic PAD is also associated with diminished walking performance during the ISWT. Thus, ISWT may show the clinical impairment in this population.
两项步行测试，即六分钟步行测试（6MWT）和递增穿梭步行测试（ISWT），被广泛用于评估疾病患者的功能能力。然而，尚不清楚这些步行测试是否能有效体现无症状外周动脉疾病（PAD）患者的临床损伤情况。我们旨在：（i）使用6MWT和ISWT比较有无无症状PAD患者的步行表现；（ii）研究踝臂指数与趾臂指数（ABI-TBI）和步行距离之间的相关性。
本研究采用横断面、交叉、配对设计。通过ABI-TBI测量诊断无症状PAD。76名参与者（38名无症状PAD患者和38名无PAD者）被随机安排进行步行测试。在6MWT中，参与者以自己选择的速度沿30米长的走廊步行6分钟，并记录所覆盖的六分钟步行距离（6MWD）。在ISWT中，参与者以规定的12个速度水平行走，并记录所覆盖的递增穿梭步行距离（ISWD）。
结果显示，无症状PAD患者与无PAD患者的6MWD无差异（平均距离：501.6米对516.8米，p = 0.24）。无症状PAD患者的ISWD明显短于无PAD患者（中位数距离：270米对340米，p = 0.003）。在6MWT和ISWT期间，没有参与者报告任何腿部疼痛症状。在所有参与者中，观察到右腿TBI与ISWD之间存在统计学上显著的正相关（r = 0.23，p = 0.04）。
当使用ISWT而非6MWT进行评估时，无症状PAD患者的步行表现比无PAD患者差。无症状PAD也与ISWT期间步行能力下降有关。因此，ISWT可能显示该人群的临床损伤情况。
