Intermittent claudication: An objective office-based assessment

Ian R. McPhail, Peter C. Spittell, Susan A. Weston, Kent R Bailey

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

OBJECTIVES: We sought to compare standard lower extremity vascular laboratory treadmill exercise with the office-based active pedal plantarflexion technique. BACKGROUND: Intermittent claudication is relatively common in elderly patients and is an important predictor of cardiovascular morbidity and mortality. Noninvasive testing using resting and posttreadmill exercise ankle:brachial systolic blood pressure indices is often required to confirm the diagnosis and objectively assess the severity of lower extremity arterial occlusive disease. This is traditionally performed in a formal vascular laboratory setting. METHODS: Fifty consecutive patients (100 lower extremities) with known or suspected intermittent claudication referred for lower extremity treadmill exercise testing were also tested with active pedal plantarflexion using a prospective, randomized crossover design. Supine ankle:brachial systolic blood pressure indices were measured immediately before and after each form of exercise. RESULTS: There was an excellent correlation (r = 0.95, 95% confidence interval 0.93 to 0.97) between mean post-exercise ankle:brachial systolic blood pressure indices for treadmill exercise and active pedal plantarflexion. There was no significant difference in outcome based on the order of testing or the severity of arterial occlusive disease. Symptoms of angina or dyspnea occurred in 11 patients (22%) with treadmill exercise versus zero patients with active pedal plantarflexion. CONCLUSIONS: Active pedal plantarflexion is an office-based test that compares favorably with treadmill exercise for the noninvasive, safe, objective and economical assessment of lower extremity arterial occlusive disease.

Original languageEnglish (US)
Pages (from-to)1381-1385
Number of pages5
JournalJournal of the American College of Cardiology
Volume37
Issue number5
DOIs
StatePublished - Apr 1 2001

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Intermittent Claudication
Exercise
Foot
Lower Extremity
Blood Pressure
Arterial Occlusive Diseases
Ankle
Arm
Blood Vessels
Dyspnea
Cross-Over Studies
Confidence Intervals
Morbidity
Mortality

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Intermittent claudication : An objective office-based assessment. / McPhail, Ian R.; Spittell, Peter C.; Weston, Susan A.; Bailey, Kent R.

In: Journal of the American College of Cardiology, Vol. 37, No. 5, 01.04.2001, p. 1381-1385.

Research output: Contribution to journalArticle

McPhail, Ian R. ; Spittell, Peter C. ; Weston, Susan A. ; Bailey, Kent R. / Intermittent claudication : An objective office-based assessment. In: Journal of the American College of Cardiology. 2001 ; Vol. 37, No. 5. pp. 1381-1385.
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