John D McCamley1, Eric J Pisciotta1, Jennifer M Yentes1, Shane R Wurdeman2, Stephen I Rennard3, Iraklis I Pipinos4, Jason M Johanning4, Sara A Myers5. 1. Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, USA. 2. Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, USA; Hanger Inc, Houston, TX, USA. 3. Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of Nebraska Medical Center, Omaha, NE, USA; Clinical Discovery Unit, AstraZeneca, Cambridge, UK. 4. Department of Surgery, Omaha Veterans' Affairs Medical Center, Omaha, NE, USA; College of Medicine, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA. 5. Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, USA; Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of Nebraska Medical Center, Omaha, NE, USA. Electronic address: samyers@unomaha.edu.
Abstract
OBJECTIVE: Previous studies have indicated that patients with peripheral artery disease (PAD), display significant differences in their kinetic and kinematic gait characteristics when compared to healthy, aged-matched controls. The ability of patients with chronic obstructive pulmonary disease (COPD) to ambulate is also limited. These limitations are likely due to pathology-driven muscle morphology and physiology alterations establish in PAD and COP, respectively. Gait changes in PAD were compared to gait changes due to COPD to further understand how altered limb muscle due to disease can alter walking patterns. Both groups were independently compared to healthy controls. It was hypothesized that both patients with PAD and COPD would demonstrate similar differences in gait when compared to healthy controls. METHODS: Patients with PAD (n=25), patients with COPD (n=16), and healthy older control subjects (n=25) performed five walking trials at self-selected speeds. Sagittal plane joint kinematic and kinetic group means were compared. RESULTS: Peak values for hip flexion angle, braking impulse, and propulsive impulse were significantly reduced in patients with symptomatic PAD compared to patients with COPD. After adjusting for walking velocity, significant reductions (p<0.05) in the peak values for hip flexion angle, dorsiflexor moment, ankle power generation, propulsion force, braking impulse, and propulsive impulse were found in patients with PAD compared to healthy controls. No significant differences were observed between patients with COPD and controls. CONCLUSIONS: The results of this study demonstrate that while gait patterns are impaired for patients with PAD, this is not apparent for patients with COPD (without PAD). PAD (without COPD) causes changes to the muscle function of the lower limbs that affects gait even when subjects walk from a fully rested state. Altered muscle function in patients with COPD does not have a similar effect.
OBJECTIVE: Previous studies have indicated that patients with peripheral artery disease (PAD), display significant differences in their kinetic and kinematic gait characteristics when compared to healthy, aged-matched controls. The ability of patients with chronic obstructive pulmonary disease (COPD) to ambulate is also limited. These limitations are likely due to pathology-driven muscle morphology and physiology alterations establish in PAD and COP, respectively. Gait changes in PAD were compared to gait changes due to COPD to further understand how altered limb muscle due to disease can alter walking patterns. Both groups were independently compared to healthy controls. It was hypothesized that both patients with PAD and COPD would demonstrate similar differences in gait when compared to healthy controls. METHODS:Patients with PAD (n=25), patients with COPD (n=16), and healthy older control subjects (n=25) performed five walking trials at self-selected speeds. Sagittal plane joint kinematic and kinetic group means were compared. RESULTS: Peak values for hip flexion angle, braking impulse, and propulsive impulse were significantly reduced in patients with symptomatic PAD compared to patients with COPD. After adjusting for walking velocity, significant reductions (p<0.05) in the peak values for hip flexion angle, dorsiflexor moment, ankle power generation, propulsion force, braking impulse, and propulsive impulse were found in patients with PAD compared to healthy controls. No significant differences were observed between patients with COPD and controls. CONCLUSIONS: The results of this study demonstrate that while gait patterns are impaired for patients with PAD, this is not apparent for patients with COPD (without PAD). PAD (without COPD) causes changes to the muscle function of the lower limbs that affects gait even when subjects walk from a fully rested state. Altered muscle function in patients with COPD does not have a similar effect.
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