Preliminary evidence that low ankle-brachial index is associated with reduced bilateral hip extensor strength and functional mobility in peripheral arterial.

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Preliminary evidence that low ankle-brachial index is associated with reduced bilateral hip extensor strength and functional mobility in peripheral arterial disease Belinda J. Parmenter, PhD, Jacqueline Raymond, PhD, Paul J. Dinnen, MD, FRACS, Robert J. Lusby, MD, FRCS, FRACS, Maria A. Fiatarone Singh, MD Journal of Vascular Surgery Volume 57, Issue 4, Pages 963-973.e1 (April 2013) DOI: 10.1016/j.jvs.2012.08.103 Copyright © 2013 Terms and Conditions

Fig 1 Nagi disablement model tailored to the Regular Exercise for Peripheral Arterial Ischemia: a Randomized Controlled Intervention Trial (REPAIR IT) pilot study hypotheses and outcomes. ABI, Ankle-brachial index; HGS, habitual gait speed; MGS, maximal gait speed; RT, recovery time; SPPB, short physical performance battery. aThe SPPB20 is a measure of lower extremity mobility14 and pools the results from the repeated chair stand, standing balance, and habitual gait speed. A lower score equals poorer function. Journal of Vascular Surgery 2013 57, 963-973.e1DOI: (10.1016/j.jvs.2012.08.103) Copyright © 2013 Terms and Conditions

Fig 2 REPAIR IT (Regular Exercise for Peripheral Arterial Ischemia: a Randomized Controlled Intervention Trial) CONSORT (Consolidated Standards of Reporting Trials) flowchart. n = sample size. Journal of Vascular Surgery 2013 57, 963-973.e1DOI: (10.1016/j.jvs.2012.08.103) Copyright © 2013 Terms and Conditions

Fig 3 Relationship between smoking and alcohol consumption and indexes of peripheral arterial disease (PAD) severity. Simple linear regression between claudication recovery time (CRT) as an index of PAD severity and lifestyle factors. A, Greater smoking history was significantly associated with longer recovery time (more severe disease; r = 0.51; P = .02). B, Greater alcohol intake was also significantly associated with longer recovery time (r = 0.57; P = .007). Because there was a nearly significant trend for men to have a higher alcohol intake than women (P = .052), gender was added to the model. This relationship attenuated but remained significant after controlling for gender in a multiple regression model (r = 0.50; P = .03). The r and P values were calculated by linear regression analysis. CTrd, Constant treadmill protocol. Journal of Vascular Surgery 2013 57, 963-973.e1DOI: (10.1016/j.jvs.2012.08.103) Copyright © 2013 Terms and Conditions

Fig 4 Relationship between ankle-brachial index (ABI) and bilateral hip extensor strength. Simple linear regression between ABI and bilateral hip extensor strength. Low ABI was significantly associated with reduced bilateral hip extensor strength (r = 0.54; P = .007). Because bilateral hip extensor strength reduced with age (P = .005) and women had weaker hip extensors than men (P = .04), age and gender were added to the model. This relationship remained after controlling for both age and gender in a multiple regression model (r = 0.54; P = .004). The r and P values were calculated by linear regression analysis. Journal of Vascular Surgery 2013 57, 963-973.e1DOI: (10.1016/j.jvs.2012.08.103) Copyright © 2013 Terms and Conditions

Fig 5 Relationship between bilateral hip extensor strength and walking ability and functional performance in subjects with peripheral arterial disease. A and B, Simple linear regression between bilateral hip extensor strength (HES) and the distance to first stop and total walking distance for the 6-minute walk (6MW). Reduced HES was significantly associated with a shorter distance to first stop during flat ground walking (A; r = 0.74; P < .001) and reduced total 6-minute walk distance (B; 6MWD; r = 0.75; P < .001). Because the distance to first stop reduced with age (P = .02) and men were significantly stronger than women (P = .004), age and gender were added to the distance to first stop model and gender to the 6MWD models. These relationship remained after controlling for age and gender in these multiple regression models (r = 0.74; P = .001; r = 0.75; P < .001 respectively). C, Simple linear regression between HES and short physical performance battery (SPPB) score. (The SPPB20 is a measure of lower extremity mobility14 and pools the results from the repeated chair stand, standing balance, and habitual gait speed. A lower score equals poorer function.) Reduced HES was significantly associated with reduced SPPB score (worse function; r = 0.59; P = .002). Because HES reduced with age (P = .004) and women had weaker hip extensors than men (P = .04), age and gender were added to the model. This relationship became stronger after controlling for both age and gender in a multiple regression model (r = 0.75; P = .003). The r and P values were calculated by linear regression analysis. Journal of Vascular Surgery 2013 57, 963-973.e1DOI: (10.1016/j.jvs.2012.08.103) Copyright © 2013 Terms and Conditions