Abstract
BackgroundPharmacological treatment has been advocated as a first line therapy for Peripheral Arterial Disease (PAD) patients suffering from intermittent claudication. Previous studies document the ability of pharmacological treatment to increase walking distances. However, the effect of pharmacological treatment on gait biomechanics in PAD patients has not been objectively evaluated as is common with other gait abnormalities.MethodsSixteen patients were prescribed an FDA approved drug (Pentoxifylline or Cilostazol) for the treatment of symptomatic PAD. Patients underwent baseline gait testing prior to medication use which consisted of acquisition of ground reaction forces and kinematics while walking in a pain free state. After three months of treatment, patients underwent repeat gait testing.ResultsPatients with symptomatic PAD had significant gait abnormalities at baseline during pain free walking as compared to healthy controls. However, pharmacological treatment did not produce any identifiable alterations on the biomechanics of gait of the PAD patients as revealed by the statistical comparisons performed between pre and post-treatment and between post-treatment and the healthy controls.ConclusionsPharmacological treatment did not result in statistically significant improvements in the gait biomechanics of patients with symptomatic PAD. Future studies will need to further explore different cohorts of patients that have shown to improve significantly their claudication distances and/or their muscle fiber morphology with the use of pharmacological treatment and determine if this is associated with an improvement in gait biomechanics. Using these methods we may distinguish the patients who benefit from pharmacotherapy and those who do not.
Highlights
Peripheral Arterial Disease (PAD) is a condition of atherosclerosis affecting the arteries of the lower extremities which results in reduced blood flow at rest with further reduction occurring with activity
The other, cilostazol, increases the intracellular concentration of the cyclic adenosine monophosphate in order to suppress platelet aggregation and increase arterial dilation [15]. The purpose of these medications is to eliminate symptoms and improve the distance walked by patients with symptomatic PAD, changes in the biomechanics of gait have not been documented as a result of pharmacological treatment in PAD patients [16]
We extended previous work utilizing the same kinematic and kinetic biomechanical measures to assess the impact of pharmacological treatment of PAD patients
Summary
Peripheral Arterial Disease (PAD) is a condition of atherosclerosis affecting the arteries of the lower extremities which results in reduced blood flow at rest with further reduction occurring with activity. PAD patients typically experience intermittent claudication symptoms. The purpose of these medications is to eliminate symptoms and improve the distance walked by patients with symptomatic PAD, changes in the biomechanics of gait have not been documented as a result of pharmacological treatment in PAD patients [16]. It is unknown if such treatment can improve the biomechanics of gait of PAD patients towards the level of normative healthy gait. Pharmacological treatment has been advocated as a first line therapy for Peripheral Arterial Disease (PAD) patients suffering from intermittent claudication. The effect of pharmacological treatment on gait biomechanics in PAD patients has not been objectively evaluated as is common with other gait abnormalities
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