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Lanzarin M, Parizoto P, Santos GM. Analysis of isokinetic muscle function and postural control in individuals with intermittent claudication. Braz J Phys Ther 2016; 20:48-57. [PMID: 26786077 PMCID: PMC4835164 DOI: 10.1590/bjpt-rbf.2014.0134] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 06/15/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND: Intermittent claudication (IC) is a debilitating condition that mostly affects
elderly people. IC is manifested by a decrease in ambulatory function. Individuals
with IC present with motor and sensory nerve dysfunction in the lower extremities,
which may lead to deficits in balance. OBJECTIVE: This study aimed to measure postural control and isokinetic muscle function in
individuals with intermittent claudication. METHOD: The study included 32 participants of both genders, 16 IC participants (mean age:
64 years, SD=6) and 16 healthy controls (mean age: 67 years, SD=5), which were
allocated into two groups: intermittent claudication group (ICG) and control group
(CG). Postural control was assessed using the displacement and velocity of the
center of pressure (COP) during the sensory organization test (SOT) and the motor
control test (MCT). Muscle function of the flexor and extensor muscles of the knee
and ankle was measured by an isokinetic dynamometer. Independent t tests were used
to calculate the between-group differences. RESULTS: The ICG presented greater displacement (p =0.027) and speed
(p =0.033) of the COP in the anteroposterior direction (COPap)
during the MCT, as well as longer latency (p =0.004). There were
no between-group differences during the SOT. The ICG showed decreased muscle
strength and power in the plantar flexors compared to the CG. CONCLUSION: Subjects with IC have lower values of strength and muscle power of
plantiflexores, as well as changes in postural control in dynamic conditions.
These individuals may be more vulnerable to falls than healthy subjects.
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Affiliation(s)
- Morgan Lanzarin
- Centro de Ciências da Saúde e Esportes, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brasil
| | - Patricia Parizoto
- Centro de Ciências da Saúde e Esportes, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brasil
| | - Gilmar M Santos
- Centro de Ciências da Saúde e Esportes, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brasil
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Myers SA, Huben NB, Yentes JM, McCamley JD, Lyden ER, Pipinos II, Johanning JM. Spatiotemporal Changes Posttreatment in Peripheral Arterial Disease. Rehabil Res Pract 2015; 2015:124023. [PMID: 26770826 PMCID: PMC4681815 DOI: 10.1155/2015/124023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 11/16/2015] [Indexed: 11/26/2022] Open
Abstract
Accumulating evidence suggests revascularization of peripheral arterial disease (PAD) limbs results in limited improvement in functional gait parameters, suggesting underlying locomotor system pathology. Spatial and temporal (ST) gait parameters are well studied in patients with PAD at baseline and are abnormal when compared to controls. The purpose of this study was to systematically review and critically analyze the available data on ST gait parameters before and after interventions. A full review of literature was conducted and articles were included which examined ST gait parameters before and after intervention (revascularization and exercise). Thirty-three intervention articles were identified based on 154 articles that evaluated ST gait parameters in PAD. Four articles fully assessed ST gait parameters before and after intervention and were included in our analysis. The systematic review of the literature revealed a limited number of studies assessing ST gait parameters. Of those found, results demonstrated the absence of improvement in gait parameters due to either exercise or surgical intervention. Our study demonstrates significant lack of research examining the effectiveness of treatments on ST gait parameters in patients with PAD. Based on the four published articles, ST gait parameters failed to significantly improve in patients with PAD following intervention.
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Affiliation(s)
- Sara A. Myers
- Center for Research in Human Movement Variability, School of Health, Physical Education, and Recreation, University of Nebraska Omaha, 6160 University Drive South, Omaha, NE 68182-0860, USA
| | - Neil B. Huben
- Center for Research in Human Movement Variability, School of Health, Physical Education, and Recreation, University of Nebraska Omaha, 6160 University Drive South, Omaha, NE 68182-0860, USA
| | - Jennifer M. Yentes
- Center for Research in Human Movement Variability, School of Health, Physical Education, and Recreation, University of Nebraska Omaha, 6160 University Drive South, Omaha, NE 68182-0860, USA
| | - John D. McCamley
- Center for Research in Human Movement Variability, School of Health, Physical Education, and Recreation, University of Nebraska Omaha, 6160 University Drive South, Omaha, NE 68182-0860, USA
| | - Elizabeth R. Lyden
- College of Public Health, Department of Biostatistics, University of Nebraska Medical Center, 984355 Nebraska Medical Center, Omaha, NE 68198, USA
| | - Iraklis I. Pipinos
- Department of Surgery, Omaha Veterans Affairs Medical Center, 4101 Woolworth Avenue (121), Omaha, NE 68105, USA
- College of Medicine, Department of Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE 68198, USA
| | - Jason M. Johanning
- Department of Surgery, Omaha Veterans Affairs Medical Center, 4101 Woolworth Avenue (121), Omaha, NE 68105, USA
- College of Medicine, Department of Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE 68198, USA
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Szulc P, Blackwell T, Schousboe JT, Bauer DC, Cawthon P, Lane NE, Cummings SR, Orwoll ES, Black DM, Ensrud KE. High hip fracture risk in men with severe aortic calcification: MrOS study. J Bone Miner Res 2014; 29:968-75. [PMID: 23983224 PMCID: PMC3935989 DOI: 10.1002/jbmr.2085] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 08/14/2013] [Accepted: 08/20/2013] [Indexed: 12/21/2022]
Abstract
A significant link between cardiovascular disease and osteoporosis is established in postmenopausal women, but data for men are scarce. We tested the hypothesis that greater severity of abdominal aortic calcification (AAC) was associated with an increased risk of nonspine fracture in 5994 men aged ≥ 65 years. AAC was assessed on 5400 baseline lateral thoracolumbar radiographs using a validated visual semiquantitative score. Total hip bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. Incident nonspine fractures were centrally adjudicated. After adjustment for age, body mass index (BMI), total hip BMD, fall history, prior fracture, smoking status, comorbidities, race, and clinical center, the risk of nonspine fracture (n=805) was increased among men with higher AAC (hazard ratio [HR] quartile 4 [Q4] [AAC score ≥ 9] versus quartile 1 [Q1] [0-1], 1.36; 96% confidence interval [CI], 1.10-1.68). This association was due to an increased risk of hip fracture (n=178) among men with higher AAC (HR Q4 versus Q1, 2.33; 95% CI, 1.41-3.87). By contrast, the association between AAC and the risk of nonspine, nonhip fracture was weaker and not significant (HR Q4 versus Q1, 1.22; 95% CI, 0.96-1.55). The findings regarding higher AAC and increased risk of fracture were not altered in additional analyses accounting for degree of trauma, estimated glomerular filtration rate, presence of lumbar vertebral fractures (which may bias AAC assessment), preexisting cardiovascular disease, ankle brachial index, or competing risk of death. Thus, in this large cohort of elderly men, greater AAC was independently associated with an increased risk of hip fracture, but not with other nonspine fractures. These findings suggest that AAC assessment may be a useful method for identification of older men at high risk of hip fracture.
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Affiliation(s)
- Pawel Szulc
- Institut National de la Santé et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR) 1033, University of Lyon, Lyon, France
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Lane RA, Mazari F, Mockford KA, Vanicek N, Chetter IC, Coughlin PA. Fear of falling in claudicants and its relationship to physical ability, balance, and quality of life. Vasc Endovascular Surg 2014; 48:297-304. [PMID: 24444769 DOI: 10.1177/1538574413519711] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Intermittent claudication is associated with poor physical function, quality of life (QoL), and balance impairment. Fear of falling (FoF) is a recognized contributing factor to poor physical ability. Any link between claudication and FoF is yet to be determined. This study aimed to explore the prevalence of FoF in claudicants and its relationship with physical function and QoL. METHODS A prospective observational study was performed. Fear of falling was determined using the Activities-specific Balance Confidence (ABC) questionnaire and the categorical question "Are you afraid of falling?" Physical ability and QoL (Short Form 36 and Vascular QoL) were determined. RESULTS A total of 161 claudicants (118 men, median age of 69 years) were assessed; 83 answered the categorical question "Are you afraid of falling?" By receiver-operating characteristic curve analysis, an ABC threshold <74% denoted a FoF, which was associated with poorer physical function and QoL. CONCLUSION Fear of falling is associated with poor physical, social, and psychological function, addressing this may improve all aspects of health.
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Affiliation(s)
- Risha A Lane
- Academic Vascular Surgical Unit, Hull Royal Infirmary, Hull, Hull York Medical School, University of Hull, United Kingdom
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Gohil RA, Mockford KA, Mazari F, Khan J, Vanicek N, Chetter IC, Coughlin PA. Balance Impairment, Physical Ability, and Its Link With Disease Severity in Patients With Intermittent Claudication. Ann Vasc Surg 2013; 27:68-74. [DOI: 10.1016/j.avsg.2012.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 05/07/2012] [Accepted: 05/14/2012] [Indexed: 10/27/2022]
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Mockford KA, Mazari FA, Jordan AR, Vanicek N, Chetter I, Coughlin PA. Computerized Dynamic Posturography in the Objective Assessment of Balance in Patients With Intermittent Claudication. Ann Vasc Surg 2011; 25:182-90. [DOI: 10.1016/j.avsg.2010.07.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Revised: 05/17/2010] [Accepted: 07/19/2010] [Indexed: 10/19/2022]
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Vavra AK, Kibbe MR. Women and Peripheral Arterial Disease. WOMENS HEALTH 2009; 5:669-83. [DOI: 10.2217/whe.09.60] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Ashley K Vavra
- Ashley K Vavra, Division of Vascular Surgery, Northwestern Feinberg School of Medicine, Chicago, IL, USA, Tel.: +1 312 503 6701, Fax: +1 312 503 1222,
| | - Melina R Kibbe
- Melina R Kibbe, Northwestern University, 676 North St Clair, Suite 650, Chicago, IL 60611, USA
- Jesse Brown Veterans Affairs Medical Center, Chicago, IL, USA, Tel.: +1 312 503 6701, Fax: +1 312 503 1222,
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