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Taoum A, Chaudru S, DE Müllenheim PY, Congnard F, Emily M, Noury-Desvaux B, Bickert S, Carrault G, Mahé G, LE Faucheur A. Comparison of Activity Monitors Accuracy in Assessing Intermittent Outdoor Walking. Med Sci Sports Exerc 2021; 53:1303-1314. [PMID: 33731660 DOI: 10.1249/mss.0000000000002587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE This study aimed to determine and compare the accuracy of different activity monitors in assessing intermittent outdoor walking in both healthy and clinical populations through the development and validation of processing methodologies. METHODS In study 1, an automated algorithm was implemented and tested for the detection of short (≤1 min) walking and stopping bouts during prescribed walking protocols performed by healthy subjects in environments with low and high levels of obstruction. The following parameters obtained from activity monitors were tested, with different recording epochs0.1s/0.033s/1s/3s/10s and wearing locationsscapula/hip/wrist/ankle: GlobalSat DG100 (GS) and Qstarz BT-Q1000XT/-Q1000eX (QS) speed; ActiGraph wGT3X+ (AG) vector magnitude (VM) raw data, VM counts, and steps; and StepWatch3 (SW) steps. Furthermore, linear mixed models were developed to estimate walking speeds and distances from the monitors parameters. Study 2 validated the performance of the activity monitors and processing methodologies in a clinical population showing profile of intermittent walking due to functional limitations during outdoor walking sessions. RESULTS In study 1, GS1s, scapula, QS1s, scapula/wrist speed, and AG0.033s, hip VM raw data provided the highest bout detection rates (>96.7%) and the lowest root mean square errors in speed (≤0.4 km·h-1) and distance (<18 m) estimation. Using SW3s, ankle steps, the root mean square error for walking/stopping duration estimation reached 13.6 min using proprietary software and 0.98 min using our algorithm (total recording duration, 282 min). In study 2, using AG0.033s, hip VM raw data, the bout detection rate (95% confidence interval) reached 100% (99%-100%), and the mean (SD) absolute percentage errors in speed and distance estimation were 9% (6.6%) and 12.5% (7.9%), respectively. CONCLUSIONS GPS receivers and AG demonstrated high performance in assessing intermittent outdoor walking in both healthy and clinical populations.
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Affiliation(s)
- Aline Taoum
- University of Rennes 2, M2S-EA 7470, Rennes, FRANCE
| | - Ségolène Chaudru
- Clinical Investigation Center, INSERM 1414, University of Rennes 1, Rennes, FRANCE
| | | | - Florian Congnard
- Institute of Physical Education and Sport Sciences (IFEPSA), UCO, Les Ponts-de-Cé, FRANCE
| | - Mathieu Emily
- Institut Agro, CNRS, Univ Rennes, IRMAR-UMR 6625, Rennes, FRANCE
| | | | - Sandrine Bickert
- Laboratory of Vascular Investigations and Sports Medicine, University Hospital, Angers, FRANCE
| | - Guy Carrault
- Univ Rennes, Inserm, LTSI-UMR 1099, Rennes, FRANCE
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de Müllenheim PY, Rouvière L, Emily M, Chaudru S, Kaladji A, Mahé G, Le Faucheur A. "Should I stay or should I go now?" Recovery time effect on walking capacity in symptomatic peripheral artery disease. J Appl Physiol (1985) 2021; 131:207-219. [PMID: 33982591 DOI: 10.1152/japplphysiol.00441.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The objective of the study was to investigate the effect of recovery time on walking capacity (WC) throughout repeated maximal walking bouts in symptomatic lower-extremity peripheral artery disease (PAD). The effect of recovery time on WC (maximal walking time) was determined in 21 participants with PAD in three experimental conditions [recovery time from 0.5 to 9.5 min + a self-selected recovery time (SSRT)]: 1) 11 repeated sequences of two treadmill walking bouts (TW-ISO); 2) a single sequence of seven treadmill walking bouts (TW-CONS); 3) a single sequence of seven outdoor walking bouts (OW-CONS). Exercise transcutaneous oxygen pressure changes were continuously recorded as an indirect measure of ischemia. An individual recovery time (IRT) beyond which WC did not substantially increased was determined in participants with a logarithmic fit. At the group level, mixed models showed a significant effect (P < 0.001) of recovery time on WC restoration. At the participant level, strong logarithmic relationships were found (median significant R2 ≥ 0.78). The median SSRT corresponded to a median work-to-rest ratio >1:1 (i.e., a lower recovery time in view of the corresponding previous walking time) and was related to unrecovered ischemia and a WC restoration level of <80%. A median work-to-rest ratio of ≤1:2 allowed full recovery of ischemia and full restoration of WC. The IRT ratio was between 1:1 and 1:2 and corresponded to the start of recovery from ischemia. Recovery time affects the restoration level of WC during repeated maximal walking bouts in symptomatic PAD. Meaningful variations in WC restoration were related to specific levels of work-to-rest ratios.NEW & NOTEWORTHY This study demonstrated that there is a significant and mostly logarithmic effect of recovery time on walking capacity in people with symptomatic PAD. This study revealed that a median work-to-rest ratio >1:1 leads to the resumption of walking with unrecovered ischemia and precludes the restoration of full walking capacity, whereas a work-to-rest ratio ≤1:2 allowed walking capacity to fully be restored.
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Affiliation(s)
- Pierre-Yves de Müllenheim
- Institute of Physical Education and Sports Sciences (IFEPSA), West Catholic University (UCO), Les Ponts-de-Cé, France
| | | | - Mathieu Emily
- Institut Agro, CNRS, University of Rennes, IRMAR-UMR CNRS 6625, Rennes, France
| | - Ségolène Chaudru
- Clinical Investigation Center, INSERM CIC, Rennes, France.,University of Rennes, Rennes, France
| | - Adrien Kaladji
- Department of Cardiothoracic and Vascular Surgery, University Hospital Rennes, Rennes, France
| | - Guillaume Mahé
- Clinical Investigation Center, INSERM CIC, Rennes, France.,University of Rennes, Rennes, France.,Vascular Medicine Unit, University Hospital Rennes, Rennes, France
| | - Alexis Le Faucheur
- Clinical Investigation Center, INSERM CIC, Rennes, France.,Univ Rennes, M2S-EA 7470, Rennes, France
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3
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Belabbas D, Koch C, Chaudru S, Lederlin M, Laviolle B, Le Pabic E, Boulmier D, Heautot JF, Mahe G. Effects of Remote Ischemic Pre-Conditioning to Prevent Contrast-Induced Nephropathy after Intravenous Contrast Medium Injection: A Randomized Controlled Trial. Korean J Radiol 2020; 21:1230-1238. [PMID: 32729273 PMCID: PMC7462761 DOI: 10.3348/kjr.2019.0916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/22/2020] [Accepted: 03/31/2020] [Indexed: 11/15/2022] Open
Abstract
Objective We aimed to assess the effects of remote ischemic pre-conditioning (RIPC) on the incidence of contrast-induced nephropathy (CIN) after an intravenous (IV) or intra-arterial injection of contrast medium (CM) in patient and control groups. Materials and Methods This prospective, randomized, single-blinded, controlled trial included 26 patients who were hospitalized for the evaluation of the feasibility of transcatheter aortic valve implantation and underwent investigations including contrast-enhanced computed tomography (CT), with Mehran risk scores greater than or equal to six. All the patients underwent four cycles of five minute-blood pressure cuff inflation followed by five minutes of total deflation. In the RIPC group (n = 13), the cuff was inflated to 50 mm Hg above the patient's systolic blood pressure (SBP); in the control group (n = 13), it was inflated to 10 mm Hg below the patient's SBP. The primary endpoint was the occurrence of CIN. Additionally, variation in the serum levels of cystatin C was assessed. Results One case of CIN was observed in the control group, whereas no cases were detected in the RIPC group (p = 0.48, analysis of 25 patients). Mean creatinine values at the baseline, 24 hours after injection of CM, and 48 hours after injection of CM were 88 ± 32 µmol/L, 91 ± 28 µmol/L and 82 ± 29 µmol/L, respectively (p = 0.73) in the RIPC group, whereas in the control group, they were 100 ± 36 µmol/L, 110 ± 36 µmol/L, and 105 ± 34 µmol/L, respectively (p = 0.78). Cystatin C values (median [Q1, Q3]) at the baseline, 24 hours after injection of CM, and 48 hours after injection of CM were 1.10 [1.08, 1.18] mg/L, 1.17 [0.97, 1.35] mg/L, and 1.12 [0.99, 1.24] mg/L, respectively (p = 0.88) in the RIPC group, whereas they were 1.11 [0.97, 1.28] mg/L, 1.13 [1.08, 1.25] mg/L, and 1.16 [1.03, 1.31] mg/L, respectively (p = 0.93), in the control group. Conclusion The risk of CIN after an IV injection of CM is very low in patients with Mehran risk score greater than or equal to six and even in the patients who are unable to receive preventive hyperhydration. Hence, the Mehran risk score may not be an appropriate method for the estimation of the risk of CIN after IV CM injection.
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Affiliation(s)
- Dihia Belabbas
- Vascular Medicine Unit, Department of Radiology, University Hospital Pontchaillou, Rennes, France
| | - Caroline Koch
- Department of Radiodology, Toulouse University Hospital, Toulouse, France
| | - Ségolène Chaudru
- Vascular Medicine Unit, Department of Radiology, University Hospital Pontchaillou, Rennes, France
| | - Mathieu Lederlin
- Vascular Medicine Unit, Department of Radiology, University Hospital Pontchaillou, Rennes, France
| | - Bruno Laviolle
- Vascular Medicine Unit, Department of Radiology, University Hospital Pontchaillou, Rennes, France
| | - Estelle Le Pabic
- Vascular Medicine Unit, Department of Radiology, University Hospital Pontchaillou, Rennes, France
| | - Dominique Boulmier
- Vascular Medicine Unit, Department of Radiology, University Hospital Pontchaillou, Rennes, France
| | - Jean François Heautot
- Vascular Medicine Unit, Department of Radiology, University Hospital Pontchaillou, Rennes, France
| | - Guillaume Mahe
- Vascular Medicine Unit, Department of Radiology, University Hospital Pontchaillou, Rennes, France.
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Chaudru S, Jehannin P, de Müllenheim PY, Klein H, Jaquinandi V, Mahé G, Le Faucheur A. Using wearable monitors to assess daily walking limitations induced by ischemic pain in peripheral artery disease. Scand J Med Sci Sports 2019; 29:1813-1826. [PMID: 31271680 DOI: 10.1111/sms.13511] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 06/05/2019] [Accepted: 06/26/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE To develop, assess the feasibility of, and determine the clinical validity of an event-based analysis method using wearable monitors to quantify walking pain manifestations (WPMs) and stops induced by walking pain (SIWPs) during daily life walking in people with peripheral artery disease (PAD). METHODS The following two conditions were studied: a standardized outdoor walking session (OWS) and a seven-day free-living measurement (FLM) period. The PAD participants (n = 23) wore an accelerometer and a watch. They were asked to press the event marker button on the watch to indicate events related to WPMs and SIWPs. To assess the clinical validity of the method, the computed pain-free walking time (PFWT) and maximal walking time (MWT) were compared with the PFWT and MWT assessed using standard treadmill walking protocols, respectively. RESULTS Following OWSs, the PFWT[OWS] and MWT[OWS] were significantly correlated with the PFWT[Strandness] (r = .955, P < .001) and MWT[Strandness] (r = .821, P < .001), respectively. During the FLM, PAD participants experienced only 2 WPMs/day and 1 SIWP/day, although severely limited on the treadmill and during the OWS. The average WPMs/day were moderately correlated with the PFWT[Strandness] (r = -.54, P = .016). The PFWT[FLM] was on average 12 times longer than the PFWT[Strandness] . Interestingly, the intensity of the walking bouts as assessed by the accelerometer counts during the FLM was significantly lower than that during the OWS (45 ± 15 vs 66 ± 20 counts/s, P < .001). CONCLUSION This new method offers opportunities for studies investigating the experience of living with PAD and the assessment of daily life walking capacity for both diagnostic and therapeutic purposes.
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Affiliation(s)
- Ségolène Chaudru
- Clinical Investigation Center, INSERM CIC 1414, Rennes, France.,Univ Rennes 1, Rennes, France
| | - Pierre Jehannin
- Clinical Investigation Center, INSERM CIC 1414, Rennes, France.,Univ Rennes 1, Rennes, France
| | | | - Hélène Klein
- Department of Sport Sciences and Physical Education, Ecole Normale Supérieure de Rennes, Bruz, France
| | - Vincent Jaquinandi
- Clinical Investigation Center, INSERM CIC 1414, Rennes, France.,Univ Rennes 1, Rennes, France.,Unité de Médecine Vasculaire, CHU, Rennes, France
| | - Guillaume Mahé
- Clinical Investigation Center, INSERM CIC 1414, Rennes, France.,Univ Rennes 1, Rennes, France.,Unité de Médecine Vasculaire, CHU, Rennes, France
| | - Alexis Le Faucheur
- Clinical Investigation Center, INSERM CIC 1414, Rennes, France.,Univ Rennes, M2S - EA 7470, Rennes, France.,Department of Sport Sciences and Physical Education, Ecole Normale Supérieure de Rennes, Bruz, France
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Omarjee L, Donnou C, Chaudru S, Locher C, Paul E, Charasson M, Mauger C, Jaquinandi V, Stivalet O, Mahe G. Impact of an Educational Intervention on Ankle–Brachial Index Performance Among Medical Students and Fidelity Assessment at Six Months. Ann Vasc Surg 2019; 56:246-253. [DOI: 10.1016/j.avsg.2018.07.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/06/2018] [Accepted: 07/07/2018] [Indexed: 10/28/2022]
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de Müllenheim PY, Chaudru S, Emily M, Gernigon M, Mahé G, Bickert S, Prioux J, Noury-Desvaux B, Le Faucheur A. Using GPS, accelerometry and heart rate to predict outdoor graded walking energy expenditure. J Sci Med Sport 2018; 21:166-172. [DOI: 10.1016/j.jsams.2017.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 09/14/2017] [Accepted: 10/05/2017] [Indexed: 01/17/2023]
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Donnou C, Chaudru S, Stivalet O, Paul E, Charasson M, Selli JM, Mauger C, Chapron A, Le Faucheur A, Jaquinandi V, Omarjee L, Mahe G. Medical students’ proficiency in performance of the resting ankle-brachial index is not sustained at 6 months. J Clin Hypertens (Greenwich) 2018; 20:609-610. [DOI: 10.1111/jch.13206] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Céline Donnou
- CHU Rennes; CIC 1414, INSERM; Univ Rennes; Rennes France
| | | | | | - Eunice Paul
- CHU Rennes; CIC 1414, INSERM; Univ Rennes; Rennes France
| | | | | | - Chadi Mauger
- CHU Rennes; CIC 1414, INSERM; Univ Rennes; Rennes France
| | | | - Alexis Le Faucheur
- Movement, Sport and Health laboratory; EA 1274, UFR APS; Université de Rennes 2 (Rennes 2 University); Rennes France
- Department of Sport Sciences and Physical Education; Campus de Ker Lann Ecole; Normale Supérieure de Rennes; Bruz France
| | | | | | - Guillaume Mahe
- CHU Rennes; CIC 1414, INSERM; Univ Rennes; Rennes France
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8
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Donnou C, Chaudru S, Stivalet O, Paul E, Charasson M, Selli JM, Mauger C, Chapron A, Le Faucheur A, Jaquinandi V, Mahé G. How to become proficient in performance of the resting ankle-brachial index: Results of the first randomized controlled trial. Vasc Med 2017; 23:109-113. [PMID: 29125051 DOI: 10.1177/1358863x17740993] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The resting ankle-brachial index (ABI) is a first-line test to diagnose peripheral artery disease (PAD). No randomized controlled trial (RCT) has yet been conducted to determine the best teaching method to become proficient in the ABI procedure. We conducted a monocentric RCT to determine whether didactic learning alone or didactic learning combined with experiential learning improved proficiency in the ABI procedure. Medical students ( n = 30) received didactic learning, including (i) a presentation of the ABI guidelines and (ii) a video demonstration. Each student was then randomized into two groups ('no experiential learning group' and 'experiential learning group'). An initial evaluation was performed after the didactic learning and a final evaluation at the end of the intervention. A student was considered to be proficient when he or she performed a correct ABI procedure on a healthy individual and a patient. The correct procedure corresponds to (i) following guidelines and (ii) a difference in ABI measurement between a vascular specialist and a student of ≤ 0.15. No student was proficient at the initial evaluation. At the final evaluation, in the didactic learning group, the number of proficient students was not improved compared with the initial evaluation (0/10 vs 1/10). In the experiential learning group, the number of proficient students was significantly improved (0/20 vs 11/20; p < 0.05). At the final evaluation, there was a significant difference between the number of proficient students depending on their learning group. In conclusion, didactic learning alone is insufficient to gain proficiency in the ABI procedure. Combining didactic learning with experiential learning significantly improved the students' proficiency.
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Affiliation(s)
- Céline Donnou
- 1 Vascular Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Ségolène Chaudru
- 2 Université de Rennes, Centre Hospitalier Universitaire de Rennes, INSERM, Centre d'Investigation Clinique 1414, Rennes, France
| | - Olivier Stivalet
- 1 Vascular Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France.,3 Vascular Medicine, Hopital de Saint-Malo, France
| | - Eunice Paul
- 1 Vascular Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France.,4 Vascular Medicine, Hospital de Dinan, France
| | - Marie Charasson
- 1 Vascular Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France.,4 Vascular Medicine, Hospital de Dinan, France
| | - Jean-Marc Selli
- 1 Vascular Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France.,5 Vascular Medicine, Hospital de Paimpol, France
| | - Chadi Mauger
- 1 Vascular Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Anthony Chapron
- 2 Université de Rennes, Centre Hospitalier Universitaire de Rennes, INSERM, Centre d'Investigation Clinique 1414, Rennes, France
| | - Alexis Le Faucheur
- 2 Université de Rennes, Centre Hospitalier Universitaire de Rennes, INSERM, Centre d'Investigation Clinique 1414, Rennes, France.,6 Movement, Sport and Health Laboratory, EA 1274, UFR STAPS, Université de Rennes 2, Rennes, France.,7 Department of Sport Sciences and Physical Education, Ecole normale supérieure de Rennes, Bruz, France
| | - Vincent Jaquinandi
- 1 Vascular Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France.,2 Université de Rennes, Centre Hospitalier Universitaire de Rennes, INSERM, Centre d'Investigation Clinique 1414, Rennes, France
| | - Guillaume Mahé
- 1 Vascular Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France.,2 Université de Rennes, Centre Hospitalier Universitaire de Rennes, INSERM, Centre d'Investigation Clinique 1414, Rennes, France
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de Müllenheim PY, Chaudru S, Gernigon M, Mahé G, Bickert S, Prioux J, Noury-Desvaux B, Le Faucheur A. Accuracy of a low-cost global positioning system receiver for estimating grade during outdoor walking. Physiol Meas 2016; 37:1741-1756. [PMID: 27653453 DOI: 10.1088/0967-3334/37/10/1741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this study was to assess, for the first time, the accuracy of a low-cost global positioning system (GPS) receiver for estimating grade during outdoor walking. Thirty subjects completed outdoor walks (2.0, 3.5 and 5.0 km · h-1) in three randomized conditions: 1/level walking on a 0.0% grade; 2/graded (uphill and downhill) walking on a 3.4% grade; and 3/on a 10.4% grade. Subjects were equipped with a GPS receiver (DG100, GlobalSat Technology Corp., Taiwan; ~US$75). The GPS receiver was set to record at 1 Hz and its antenna was placed on the right shoulder. Grade was calculated from GPS speed and altitude data (grade = altitude variation/travelled distance × 100). Two methods were used for the grade calculation: one using uncorrected altitude data given by the GPS receiver and another one using corrected altitude data obtained using map projection software (CartoExploreur, version 3.11.0, build 2.6.6.22, Bayo Ltd, Appoigny, France, ~US$35). Linear regression of GPS-estimated versus actual grade with R 2 coefficients, bias with 95% limits of agreement (±95% LoA), and typical error of the estimate with 95% confidence interval (TEE (95% CI)) were computed to assess the accuracy of the GPS receiver. 444 walking periods were performed. Using uncorrected altitude data, we obtained: R 2 = 0.88 (p < 0.001), bias = 0.0 ± 6.6%, TEE between 1.9 (1.7-2.2)% and 4.2 (3.6-4.9)% according to the grade level. Using corrected altitude data, we obtained: R 2 = 0.98 (p < 0.001), bias = 0.2 ± 1.9%, TEE between 0.2 (0.2-0.3)% and 1.0 (0.9-1.2)% according to the grade level. The low-cost GPS receiver used was weakly accurate for estimating grade during outdoor walking when using uncorrected altitude data. However, the accuracy was greatly improved when using corrected altitude data. This study supports the potential interest of using GPS for estimating energy expenditure during outdoor walking.
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Affiliation(s)
- Pierre-Yves de Müllenheim
- Movement, Sport and Health Laboratory (EA 1274), Faculty of Sport Sciences, University of Rennes 2, F-35000 Rennes, France
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Koch C, Chauve E, Chaudru S, Le Faucheur A, Jaquinandi V, Mahé G. Exercise transcutaneous oxygen pressure measurement has good sensitivity and specificity to detect lower extremity arterial stenosis assessed by computed tomography angiography. Medicine (Baltimore) 2016; 95:e4522. [PMID: 27603342 PMCID: PMC5023864 DOI: 10.1097/md.0000000000004522] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Peripheral artery disease (PAD) is a highly prevalent disease diagnosed by the use of ankle-brachial index (ABI) at rest. In some clinical conditions (diabetes, renal insufficiency, advanced age), ABI can be falsely normal and other tests are required for the PAD diagnosis (American Heart Association statement). This study was conducted to determine the accuracy of exercise transcutaneous oxygen pressure measurement (exercise-TcPo2) in detection of arterial stenosis ≥50% using computed tomography angiography (CTA) as the gold standard.We retrospectively analyzed consecutive patients referred to our vascular unit (University Hospital, Rennes, France) for exercise-TcPo2 testing from 2014 to 2015. All included patients had a CTA performed within 3 months of the exercise-TcPo2 test. Exercise-TcPo2 was performed on treadmill (10% slope; 2 mph speed). We calculated the Delta from Resting Oxygen Pressure (DROP) index (expressed in mm Hg) at the proximal and distal levels. Two blinded physicians performed stenosis quantification on CTA. The receiver operating characteristic (ROC) curve was used to define a cutoff point to detect arterial stenosis ≥50%, stenosis ≥60%, and stenosis ≥70%.A total of 34 patients (mean age 64 ± 2 years old; 74% men) were analyzed. The highest areas under the curve (AUC) were found for 60% stenosis at both proximal and distal levels. For stenosis ≥50%, sensitivity and specificity of proximal minimal DROP were 80.9% [67.1-89.7], 81.0% [59.3-92.7] respectively. For stenosis ≥50%, sensitivity and specificity of distal minimal DROP were 73.2% [60.3-83.1], 83.3% [53.8-96.2], respectively. For stenosis ≥60%, sensitivity and specificity of proximal minimal DROP were 82.5% [67.6-91.5] and 85.7% [67.7-94.8] respectively. For stenosis ≥60%, sensitivity and specificity of distal minimal DROP were 80.4% [67.3-89.1] and 88.2% [64.2-97.7], respectively. For stenosis ≥70%, sensitivity and specificity of proximal minimal DROP were 85.7% [67.7-94.8] and 75.0% [59.6-85.9] respectively. For stenosis ≥70%, sensitivity and specificity of distal minimal DROP were 86.0% [72.2-93.7] and 76.0% [56.1-88.7], respectively.Exercise-TcPo2 using a proximal minimal DROP value ≤-15 mm Hg or a distal minimal DROP value ≤-16 mm Hg is accurate to diagnose arterial stenosis especially stenosis ≥60% on the lower limbs. Exercise-TcPo2 is safe and noninvasive test that might be used in second line for PAD diagnosis.
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Affiliation(s)
| | | | - Ségolène Chaudru
- CHU Rennes, Imagerie Cœur-Vaisseaux
- INSERM, Centre d’investigation clinique 1414
| | - Alexis Le Faucheur
- INSERM, Centre d’investigation clinique 1414
- Movement, Sport and Health Laboratory, EA 1274, UFR APS, University of Rennes, Rennes
- Department of Sport Sciences and Physical Education, ENS Rennes, Bruz
| | - Vincent Jaquinandi
- CHU Rennes, Imagerie Cœur-Vaisseaux
- INSERM, Centre d’investigation clinique 1414
| | - Guillaume Mahé
- CHU Rennes, Imagerie Cœur-Vaisseaux
- INSERM, Centre d’investigation clinique 1414
- Université de Rennes 1, Rennes, France
- Correspondence: Guillaume Mahe, Pôle Imagerie Médicale et Explorations Fonctionnelles, Hôpital Pontchaillou, 2 rue Henri Le Guilloux, Rennes, F-35033, France (e-mail: )
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11
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Koch C, Chaudru S, Lederlin M, Jaquinandi V, Kaladji A, Mahé G. Remote Ischemic Preconditioning and Contrast-Induced Nephropathy: A Systematic Review. Ann Vasc Surg 2016; 32:176-87. [DOI: 10.1016/j.avsg.2015.10.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/13/2015] [Accepted: 10/15/2015] [Indexed: 12/01/2022]
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Koch C, Chaudru S, Jaquinandi V, Mahé G, Raoult H. Re. "Contrast Induced Nephropathy and Long-term Renal Decline After Percutaneous Transluminal Angioplasty for Symptomatic Peripheral Arterial Disease". Eur J Vasc Endovasc Surg 2016; 51:605. [PMID: 26854210 DOI: 10.1016/j.ejvs.2015.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 10/25/2015] [Indexed: 11/16/2022]
Affiliation(s)
- C Koch
- CHU Rennes, Imagerie, Rennes, France
| | - S Chaudru
- INSERM, Centre d'investigation Clinique CIC 1414, Rennes, France
| | | | - G Mahé
- INSERM, Centre d'investigation Clinique CIC 1414, Rennes, France; CHU Rennes, Imagerie Cœur-Vaisseaux, Rennes, France.
| | - H Raoult
- CHU Rennes, Imagerie, Rennes, France
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Chaudru S, de Müllenheim PY, Le Faucheur A, Jaquinandi V, Kaladji A, Mahe G. Knowledge about ankle-brachial index procedure among residents: being experienced is beneficial but is not enough. VASA 2016; 45:37-41. [DOI: 10.1024/0301-1526/a000493] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. Background: Ankle-brachial index (ABI) at rest is the main clinical tool to diagnose the presence of lower extremity peripheral artery disease (PAD). The method for ABI procedure (i.e., measurement, calculation and interpretation) is standardised and guidelines were published in 2012. This study sought to: i) assess knowledge about the three major steps of the ABI procedure (i.e., measurement, calculation and interpretation) among residents from different medical schools, ii) compare the ABI knowledge of experienced residents (i.e., who have already performed ABI procedure more than 20 times) with the knowledge of inexperienced residents, and iii) describe the most common errors by residents. Methods: Residents from six medical schools were invited to complete a questionnaire about the ABI procedure. Results: Sixty-eight residents completed the questionnaire. None of them knew how to perform the entire ABI procedure. Overall, 22 %, 13 % and 41 % of residents correctly answered questions about ABI measurement, ABI calculation and ABI interpretation, respectively. Score comparisons underlined the fact that experienced residents (n = 26) answered ABI measurement questions to a significantly better level and had a significantly higher total score than inexperienced residents (n = 42) (P = 0.0485 and P = 0.0332, respectively). Errors were similar for most of the residents. Conclusions: Our study confirms that experienced residents have significantly better ABI procedure knowledge than inexperienced residents. However, none of them are able to perform the entire ABI procedure without any mistake with regard to current guidelines. It is important that training be given to residents in medical schools in order to improve their ABI procedure knowledge.
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Affiliation(s)
| | | | - Alexis Le Faucheur
- Inserm, Centre d’Investigation Clinique 1414, Rennes, France
- Movement, Sport and Health Laboratory, University of Rennes 2, France
- Department of sport sciences and physical education, ENS Rennes, Campus de Ker Lann, Rennes, France
| | | | - Adrien Kaladji
- Cabinet d’Angiologie, University of Rennes, France
- Inserm U1099, Signal and Image Processing Laboratory, University of Rennes
| | - Guillaume Mahe
- Inserm, Centre d’Investigation Clinique 1414, Rennes, France
- Cabinet d’Angiologie, University of Rennes, France
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Koch C, Chaudru S, Jaquinandi V, Mahé G. Re. 'Remote Ischemic Preconditioning to Reduce Contrast-Induced Nephropathy: a Randomized Controlled Trial'. Eur J Vasc Endovasc Surg 2015; 50:540. [PMID: 26188718 DOI: 10.1016/j.ejvs.2015.06.076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 06/10/2015] [Indexed: 11/30/2022]
Affiliation(s)
- C Koch
- CHU Rennes, Imagerie, Rennes, France
| | - S Chaudru
- INSERM, Centre d'investigation clinique CIC 14 14, Rennes, France
| | | | - G Mahé
- INSERM, Centre d'investigation clinique, Rennes, France; CHU Rennes, Imagerie Cœur-Vaisseaux, Rennes, France.
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de Müllenheim PY, Chaudru S, Mahé G, Prioux J, Le Faucheur A. Clinical Interest of Ambulatory Assessment of Physical Activity and Walking Capacity in Peripheral Artery Disease. Scand J Med Sci Sports 2015; 26:716-30. [PMID: 26173488 DOI: 10.1111/sms.12512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2015] [Indexed: 12/14/2022]
Abstract
The purpose of the present review was to provide, for the first time, a comprehensive analysis and synthesis of the available studies that highlighted the clinical interest of the ambulatory assessment of either physical activity (PA) or walking capacity in patients with lower extremity peripheral artery disease (PAD). We identified 96 related articles published up to March 2015 through a computer-assisted search of the MEDLINE, EMBASE, and Web of Science databases. Ambulatory-measured PA or related energy expenditure (EE) in PAD patients was performed in 87 of the 96 included studies. The main clinical interests of these measurements were (a) the assessment of PA/EE pattern; (b) the characterization of walking pattern; and (c) the control of training load during home-based walking programs. Ambulatory-measured walking capacity was performed in the remaining studies, using either Global Positioning System receivers or the Peripheral Arterial Disease Holter Control device. Highlighted clinical interests were (a) the assessment of community-based walking capacity; (b) the use of new outcomes to characterize walking capacity, besides the conventional absolute claudication distance; and (c) the association with the patient's self-perception of walking capacity. This review also provides for the clinicians step-by-step recommendations to specifically assess PA or walking capacity in PAD patients.
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Affiliation(s)
- P-Y de Müllenheim
- Movement, Sport and Health Laboratory, University of Rennes 2, Rennes, France
| | - S Chaudru
- INSERM, Centre d'Investigation Clinique, Rennes, France
| | - G Mahé
- INSERM, Centre d'Investigation Clinique, Rennes, France.,CHU Rennes, Imagerie Coeur-Vaisseaux, Rennes, France
| | - J Prioux
- Movement, Sport and Health Laboratory, University of Rennes 2, Rennes, France.,Department of Sport Sciences and Physical Education, ENS Rennes, Bruz, France
| | - A Le Faucheur
- Movement, Sport and Health Laboratory, University of Rennes 2, Rennes, France.,INSERM, Centre d'Investigation Clinique, Rennes, France.,Department of Sport Sciences and Physical Education, ENS Rennes, Bruz, France
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