Percutaneous transluminal angioplasty results in improved physical function but not balance in patients with intermittent claudication

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.