Intermittent
claudication is a common condition affecting over 5% of the population over the
age of 65 years. Patients exhibit limited walking ability, but over recent
years a number of studies have identified that claudication is also
associated with significant impairments in overall physical function,including
walking speed, lower limb strength, and balance.
There is strong evidence that higher levels of daily activity in claudicants
reduces functional decline and associated morbidity/mortality in the mid to
long term. Furthermore, there is increasing evidence that claudicants have
associated balance impairments that may predispose to an increased risk of
falling and its associated physical and socio-economic consequences.
Percutaneous
transluminal angioplasty results in improved physical function but not
balance in patients with intermittent claudication Risha Arun Gohil, et al Objective: The aim of this study was to
identify whether revascularization by percutaneous transluminal angioplasty
(PTA) for patients with intermittent claudication improved measures of
functional performance including balance. Methods: A prospective observational study was performed at a
single tertiary vascular center. Patients with symptomatic intermittent
claudication (Rutherford grades 1-3) were recruited to the study. Participants
were assessed at baseline (pre-PTA) and then, and 12 months post-PTA for
markers of (1) lower limb ischemia (treadmill walking distances and
ankle-brachial pressure index), (2) physical function (6-minute walk, Timed Up
and Go, and chair stand time), (3) balance impairment using computerized
dynamic posturography with the Sensory Organization Test, and (4) quality of
life (VascuQoL and Short Form Health Survey [SF-36]). Results: Forty-three participants underwent PTA. Over 12 months, a
significant improvement was demonstrated in initial (P =
.04) and maximum treadmill walking distance (P = .019).
Physical functional ability improved across all outcome measures (P < .02), and some domains of both generic (P < .03) and disease-specific quality of life (P < .01). No significant improvement in balance
was demonstrated by the Sensory Organization Test (P = .24).
Conclusions: Balance impairment is common in
claudicants and does not improve with revascularization. Further
research regarding effective treatment of balance impairment is required
in this specific group of patients.
