Ground Reaction Forces in Patients with Unilateral Peripheral Arterial Disease

Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis significantly reducing arterial blood to the lower extremities. Up to 12 million people in the USA suffer from PAD with claudication as the most common clinical manifestation. These claudicants have an inability to ambulate with a normal gait secondary to pain and fatigue of ischemic muscles. As the affected muscle becomes progressively ischemic, ambulation becomes impaired and eventually must cease to allow for reperfusion. This moderate to severe claudication limits a person’s ability to walk and perform activities of daily living (McCully et al., 1999). Our previous work has established that biomechanical differences exist in the gait patterns of bilateral PAD patients as compared to controls (Scott et al, 2005). Unilateral PAD is a common clinical condition where patients experience claudication solely in one leg. Research involving other unilateral pathologies has demonstrated that asymmetries exist due to compensations of the unaffected leg (Schmid et al, 2005; Viton et al, 2000). However, no such information is available for unilateral PAD. The purpose of this study was to investigate potential gait adaptations occurring in unilateral PAD patients. Specifically, we compared the selected parameters of ground reaction forces (GRF) in the vertical (Fz), the anterior-posterior (Fy) and the mediolateral (Fx) directions between (a) the claudicating and the contralateral healthy leg in unilateral PAD patients, and (b) both legs of unilateral PAD patients and healthy controls.