The Relationship Between Peripheral Artery Disease Symptomatology and Ischemia.
Erica N Schorr, Diane Treat-Jacobson, Ruth Lindquist
PMID 28858146WHAT IT FOUND
People with PAD often reported discomfort outside the calf or used atypical descriptors during treadmill testing.
Only 69.2% of tests stopped for classic calf discomfort, and classic descriptors were used 55.4% of the time.
Key findings
01Only 69.2% of exercise tests were stopped for discomfort in the calf at maximum intensity, and classic descriptors were used 55.4% of the time for maximum calf discomfort.
02Tight was the most common atypical descriptor for maximum calf discomfort, and atypical symptom-limiting locations included the hip, hamstring, foot, and heel.
03At self-reported full recovery, average calf tissue oxygenation was higher than baseline.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The sample was 40 participants, mostly male, Caucasian, and highly educated, and recruited from one parent study in one geographical location, so results may not apply to other people with PAD. The study was descriptive and exploratory, not designed to prove that a treatment works or that symptom reporting predicts tissue oxygenation in all PAD patients. Exercise protocols were individualized rather than standardized, so results may not compare directly with routine treadmill tests. Near-infrared spectroscopy could not account for collaterals, cardiac function, medication effects, vessel wall stiffness, or comorbid conditions that may influence calf tissue oxygenation. Calf adipose tissue thickness and skin temperature were not measured.
Declared interests
The authors reported no conflicts of interest. The article is listed as supported by NIH extramural and non-U.S. government research.
The easy way to misread this
Do not conclude that PAD discomfort always appears as calf ache or cramp, or that a patient's report of recovery proves calf tissue oxygenation has returned to baseline. This was a small descriptive study of 40 participants, not a test of treatment efficacy.