Gait variability in patients with peripheral arterial disease

外周动脉疾病患者的步态变异

• 批准号: 9057584
• 负责人: Sara A Myers
• 金额: $ 19.58万
• 依托单位: UNIVERSITY OF NEBRASKA OMAHA
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9057584
• 关键词: Address; Affect; Age; Age-Years; American; Ankle; Arteries; Articular Range of Motion; Atherosclerosis; Blood Vessels; Brain; Characteristics; Clinic; Clinical; Collaborations; Comorbidity; Complex; Consensus; Data; Decision Making; Diabetes Mellitus; Diabetic ulcer; Disease; Ensure; Entropy; Environment; Evaluation; Foot Ulcer; Functional disorder; Funding; Gait; Gait abnormality; Goals; Health; Human; Impairment; Individual; Leg; Limb structure; Lower Extremity; Measures; Mentorship; Methods; Motor; Movement; Musculoskeletal System; Myalgia; Operative Surgical Procedures; Outcome; Pathology; Patient Care; Patients; Peripheral Nerves; Peripheral arterial disease; Physical Function; Physicians; Positioning Attribute; Principal Investigator; Quality of life; Questionnaires; Research; Research Project Grants; SF-36; Sampling; Senior Scientist; Severity of illness; Structure; Surgeon; System; Testing; Ulcer; United States National Institutes of Health; Variant; Visit; Walking; Work; claudication; clinical care; clinical decision-making; clinical predictors; design; experience; fall risk; falls; functional improvement; hemodynamics; improved; indexing; non-diabetic; prevent; response; tool

PAD is a manifestation of systemic atherosclerosis, characterized by atherosclerotic blockages ofthe arteries supplying the legs. Claudication, defined as walking induced gait dysfunction and muscle pain, is the most common manifestation of PAD. Claudication affects 5% of Americans older than 55 years of age. Claudicating patients experience reduced mobility, reduced physical functioning, poor health outcomes, and increased risk for falls. To investigate the mobility issues in patients with PAD, Dr. Myers, the PI of this research project, has assessed lower extremity function by measuring amount (standard deviation and coefficient of variation) and temporal structure (largest Lyapunov exponent, sample entropy) of the stride-tostride fluctuations that exist during walking or simply termed gait variability. Such measures are emerging as important investigative tools to study clinical gait disorders, as they are predictors of falls and reflect individuals' capabilities to adapt within the movement environment. Dr. Myers' studies show that patients with PAD have altered gait variability as compared with healthy age-matched controls. Thus, this research project will utilize gait variability to determine the impact of common PAD related pathologies as well as determine if gait variability can predict clinical disease parameters (hemodynamics, walking distance, quality of life) at baseline and following surgical revascularization. The central hypothesis is that gait variability is indicative of lower extremity health outcomes and could guide clinical decision-making. Gait variability can establish the impact of PAD-related pathologies (diabetes and non-healing, shallow ulcers) on lower extremity function in patients. Determining which gait variability parameter is the best predictor of clinical disease parameters and of lower extremity function improvements post-surgical revascularization would significantly change how treatment decisions are being made. Gait variability potentially gives physicians an objective method to guide treatment decisions. Collectively, this work progresses treatment practice to ensure only patients who will significantly benefit will undergo invasive surgical procedures.

PAD是全身性动脉粥样硬化的表现，其特征是动脉粥样硬化的阻塞 供应腿的动脉。被定义为步行诱导的步态功能障碍和肌肉疼痛的lau不平是 垫的最常见表现。 lau不休影响55岁以上的美国人5％。 laudiratiencitation患者的活动能力降低，身体功能降低，健康状况不佳和 跌倒的风险增加。为了调查PAD患者Myers博士的流动性问题， 研究项目已通过测量量（标准偏差和 变异系数）和时间结构（最大的Lyapunov指数，样品熵） 步行过程中存在或简单称为步态变异性的波动。这样的措施正在出现 研究临床步态障碍的重要研究工具，因为它们是跌倒的预测因素，并且反映了 个人在运动环境中适应的能力。迈尔斯博士的研究表明患者 与健康年龄匹配的对照相比，使用PAD的步态变异性改变了。因此，这项研究 项目将利用步态变异性来确定相关病理的影响以及 确定步态变异性是否可以预测临床疾病参数（血液动力学，步行距离，质量 生命的基线和手术血运重建。中心假设是步态变异性是 指示下肢健康结果，可以指导临床决策。步态变异性可以 建立与垫相关的病理（糖尿病和非愈合，浅溃疡）的影响 患者的肢体功能。确定哪个步态变异性参数是临床的最佳预测指标 疾病参数和下肢功能改善手术后血运重建后将 显着改变了如何做出治疗决策。步态变异可能会给医生一个 指导治疗决策的客观方法。总的来说，这项工作将治疗实践发展为 确保只有显着受益的患者才能接受侵入性手术程序。