The Effect of Pharmacologic Therapy on Kinetic Gait Parameters in Patients with Peripheral Arterial Disease

Peripheral Arterial Disease (PAD) is a manifestation of atherosclerosis of the leg arteries that affects 10 million people in USA (Antignani, 2003). For these people, walking is a difficult task because the increased metabolic demands of the leg muscles are constrained due to the decreased blood flow. The result is claudication, defined as pain of the leg muscles during ambulation and is present in 40% of all PAD patients (Schainfeld, 2001). With rest, adequate blood flow eventually returns and the pain subsides. Claudication symptoms are treated with behavioral modifications, surgery and pharmacologically (Shainfeld, 2001). The two most prevalent pharmacological therapies use different approaches; the first (Treatment 1; T1) acts primarily by decreasing blood viscosity, while the second (Treatment 2; T2) acts primarily as a vasodilator (Dawson, 2001). Recently, research has examined PAD and the associated claudication as a primary gait disability (Gardner et al., 2001). However, this research has included only temporal and spatial parameters, such as stride length and step time, without exploring joint kinematics and kinetics. Similarly, studies investigating the effects of T1 and T2 also used the same limited approaches (Dawson et al., 2000). Thus, Gardner et al. (2001) suggested that these previous evaluations have been incomplete in their ability to describe the true gait handicap of PAD. Our goal was to further understand PAD gait and the influence of pharmacological therapies on the elimination of gait abnormalities. METHODS