Gait deficiencies associated with peripheral artery disease are different than chronic obstructive pulmonary disease.
John D McCamley, Eric J Pisciotta, Jennifer M Yentes and 5 others
PMID 28683417WHAT IT FOUND
People with peripheral artery disease had reduced push-off forces and ankle power before pain.
People with chronic obstructive pulmonary disease at rest and walking their own speed looked like healthy controls. The gait problem is disease-specific.
Key findings
01Patients with PAD produced smaller push-off vertical force, anterior-posterior propulsive force, propulsive impulse, and ankle power than controls, and less ankle power than patients with COPD.
02Patients with PAD had less hip flexion at weight acceptance than controls and patients with COPD, and patients with COPD did not differ from controls on this measure.
03After adjusting for walking speed, PAD still showed reduced hip flexion, lower braking impulse, reduced ankle power at push-off, lower propulsive force, and lower propulsive impulse.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The chronic obstructive pulmonary disease group had only 16 participants, and the paper says their disease severity was low, so gait problems in this group could be smaller than in other chronic obstructive pulmonary disease patients. Blood oxygen levels were not recorded, so oxygenation during the walking test is unknown for chronic obstructive pulmonary disease patients. Participants rested between trials so pain or fatigue was not present. Peripheral artery disease was tested before claudication pain, and chronic obstructive pulmonary disease was tested at rest. Patients with peripheral artery disease walked slower than controls. After adjusting for walking speed, only six of 14 significant variables remained different. The study excluded comorbidities such as cardiac, pulmonary, neuromuscular, musculoskeletal, back, or lower extremity problems, so it may not reflect patients with several conditions at once. The paper did not test an exercise or rehabilitation program.
Declared interests
The named authors declare no conflicts of interest. The supplied text does not state who funded the study.
The easy way to misread this
Do not conclude that chronic obstructive pulmonary disease causes no gait problems. The chronic obstructive pulmonary disease group was tested at rest, had low disease severity, and had only 16 participants, while gait changes in chronic obstructive pulmonary disease have been reported after fatigue.