Percutaneous transluminal angioplasty results in improved physical function but not balance in patients with intermittent claudication

• Published in: Journal of vascular surgery 2013-12, Vol.58 (6), p.1533-1539
• Main Authors: Gohil, Risha Arun, MBChB, MRCS, Mockford, Katherine A., MBChB, MRCS, Mazari, Fayyaz A., MBChB, MRCS, Khan, Junaid A., MBChB, MRCS, Van Vanicek, Natalie, PhD, Chetter, Ian C., MBChB, FRCS, Coughlin, Patrick A., MBChB, FRCS
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty - methods; Exercise Test; Exercise Tolerance - physiology; Female; Follow-Up Studies; Humans; Intermittent Claudication - physiopathology; Intermittent Claudication - therapy; Male; Middle Aged; Postural Balance - physiology; Prospective Studies; Quality of Life; Surgery; Surveys and Questionnaires; Treatment Outcome; Walking - physiology
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2013.05.106

Objective The aim of this study was to identify whether revascularization by percutaneous transluminal angioplasty (PTA) for patients with intermittent claudication improved measures of functional performance including balance. Methods A prospective observational study was performed at a single tertiary vascular center. Patients with symptomatic intermittent claudication (Rutherford grades 1-3) were recruited to the study. Participants were assessed at baseline (pre-PTA) and then 3, 6, and 12 months post-PTA for markers of (1) lower limb ischemia (treadmill walking distances and ankle-brachial pressure index), (2) physical function (6-minute walk, Timed Up and Go, and chair stand time), (3) balance impairment using computerized dynamic posturography with the Sensory Organization Test, and (4) quality of life (VascuQoL and Short Form Health Survey [SF-36]). Results Forty-three participants underwent PTA. Over 12 months, a significant improvement was demonstrated in initial ( P  = .04) and maximum treadmill walking distance ( P  = .019). Physical functional ability improved across all outcome measures ( P  < .02), and some domains of both generic ( P  < .03) and disease-specific quality of life ( P  < .01). No significant improvement in balance was demonstrated by the Sensory Organization Test ( P  = .24). Conclusions Balance impairment is common in claudicants and does not improve with revascularization. Further research regarding effective treatment of balance impairment is required in this specific group of patients.