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Treadmill Measured vs. Questionnaire Estimated Changes in Walking Ability in Patients With Peripheral Artery Disease.

Identifieur interne : 000382 ( Main/Exploration ); précédent : 000381; suivant : 000383

Treadmill Measured vs. Questionnaire Estimated Changes in Walking Ability in Patients With Peripheral Artery Disease.

Auteurs : Samir Henni [France] ; Myriam Ammi [France] ; Yves Semporé [Burkina Faso] ; Jeanne Hersant [France] ; Geoffrey Zegar [France] ; Anne-Sophie Gourdier [France] ; Jean Picquet [France] ; Pierre Abraham [France]

Source :

RBID : pubmed:30982731

Descripteurs français

English descriptors

Abstract

OBJECTIVE

Determining the maximum walking time (MWT) using the treadmill test is the gold standard method for evaluating walking capacity and treatment effect in patients with peripheral arterial disease (PAD). However, self reported functional disability is important when assessing quality of life. Changes in the Walking Estimated Limitation Calculated by History (WELCH) questionnaire scores were compared with the MWT.

METHODS

A cross sectional study was performed in patients with intermittent claudication. The treadmill test (3.2 km/h; 10% gradient) and WELCH questionnaire were administered to all patients for objective evaluation of walking capacity. Given the log normal distribution of these parameters in patients with PAD, a log transformation was applied to the WELCH score (LnW) and maximum walking time (LnT). The responsiveness of the WELCH score was determined using mean changes and correlation coefficients of LnW and LnT changes. The effect of time on the "estimated minus real" (E - R) changes (LnW - change minus LnT - change) was assessed after categorisation of patients into various test-retest intervals. Patients who underwent lower limb revascularisation between the two tests and those who underwent medical treatment only were analysed.

RESULTS

Correlation coefficients between LnW and LnT for tests 1 and 2 were r = 0.514 and r = 0.503, respectively (p < .001, for both). Correlation for LnW change vs. LnT change was 0.384 (p < .001). E - R was positive only early after surgery. E - R was negative for all test-retest intervals >1 year in revascularised and non-revascularised patients.

CONCLUSION

Changes in WELCH scores correlated with changes observed on the treadmill in patients with intermittent claudication. For long test-retest intervals, WELCH changes tended to overestimate the worsening of walking impairment as compared with the measured difference observed in both revascularised and non-revascularised patients. A shortlived "honeymoon" (overestimation of the benefit for the shortest test-retest interval) was observed only in revascularised patients.


DOI: 10.1016/j.ejvs.2018.11.015
PubMed: 30982731


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Le document en format XML

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<term>Conservative Treatment (methods)</term>
<term>Correlation of Data (MeSH)</term>
<term>Disability Evaluation (MeSH)</term>
<term>Exercise Test (methods)</term>
<term>Exercise Tolerance (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Intermittent Claudication (diagnosis)</term>
<term>Intermittent Claudication (physiopathology)</term>
<term>Intermittent Claudication (psychology)</term>
<term>Intermittent Claudication (therapy)</term>
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<term>Claudication intermittente (physiopathologie)</term>
<term>Claudication intermittente (psychologie)</term>
<term>Claudication intermittente (thérapie)</term>
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<term>Marche à pied (psychologie)</term>
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<term>Maladie artérielle périphérique</term>
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<term>Épreuve d'effort</term>
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<term>Marche à pied</term>
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<term>Walking</term>
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<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr">
<term>Claudication intermittente</term>
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<term>Intermittent Claudication</term>
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<keywords scheme="MESH" qualifier="psychologie" xml:lang="fr">
<term>Claudication intermittente</term>
<term>Marche à pied</term>
</keywords>
<keywords scheme="MESH" qualifier="psychology" xml:lang="en">
<term>Intermittent Claudication</term>
<term>Walking</term>
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<term>Intermittent Claudication</term>
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<term>Claudication intermittente</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Aged</term>
<term>Correlation of Data</term>
<term>Disability Evaluation</term>
<term>Exercise Tolerance</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Outcome Assessment, Health Care</term>
<term>Quality of Life</term>
<term>Surveys and Questionnaires</term>
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<term>Adulte d'âge moyen</term>
<term>Corrélation de données</term>
<term>Enquêtes et questionnaires</term>
<term>Femelle</term>
<term>Humains</term>
<term>Mâle</term>
<term>Qualité de vie</term>
<term>Sujet âgé</term>
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<div type="abstract" xml:lang="en">
<p>
<b>OBJECTIVE</b>
</p>
<p>Determining the maximum walking time (MWT) using the treadmill test is the gold standard method for evaluating walking capacity and treatment effect in patients with peripheral arterial disease (PAD). However, self reported functional disability is important when assessing quality of life. Changes in the Walking Estimated Limitation Calculated by History (WELCH) questionnaire scores were compared with the MWT.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>A cross sectional study was performed in patients with intermittent claudication. The treadmill test (3.2 km/h; 10% gradient) and WELCH questionnaire were administered to all patients for objective evaluation of walking capacity. Given the log normal distribution of these parameters in patients with PAD, a log transformation was applied to the WELCH score (LnW) and maximum walking time (LnT). The responsiveness of the WELCH score was determined using mean changes and correlation coefficients of LnW and LnT changes. The effect of time on the "estimated minus real" (E - R) changes (LnW - change minus LnT - change) was assessed after categorisation of patients into various test-retest intervals. Patients who underwent lower limb revascularisation between the two tests and those who underwent medical treatment only were analysed.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Correlation coefficients between LnW and LnT for tests 1 and 2 were r = 0.514 and r = 0.503, respectively (p < .001, for both). Correlation for LnW change vs. LnT change was 0.384 (p < .001). E - R was positive only early after surgery. E - R was negative for all test-retest intervals >1 year in revascularised and non-revascularised patients.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>Changes in WELCH scores correlated with changes observed on the treadmill in patients with intermittent claudication. For long test-retest intervals, WELCH changes tended to overestimate the worsening of walking impairment as compared with the measured difference observed in both revascularised and non-revascularised patients. A shortlived "honeymoon" (overestimation of the benefit for the shortest test-retest interval) was observed only in revascularised patients.</p>
</div>
</front>
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<Year>2019</Year>
<Month>06</Month>
<Day>04</Day>
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<Year>2019</Year>
<Month>12</Month>
<Day>10</Day>
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<Journal>
<ISSN IssnType="Electronic">1532-2165</ISSN>
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<Volume>57</Volume>
<Issue>5</Issue>
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<Year>2019</Year>
<Month>05</Month>
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<Title>European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery</Title>
<ISOAbbreviation>Eur J Vasc Endovasc Surg</ISOAbbreviation>
</Journal>
<ArticleTitle>Treadmill Measured vs. Questionnaire Estimated Changes in Walking Ability in Patients With Peripheral Artery Disease.</ArticleTitle>
<Pagination>
<MedlinePgn>676-684</MedlinePgn>
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<Abstract>
<AbstractText Label="OBJECTIVE">Determining the maximum walking time (MWT) using the treadmill test is the gold standard method for evaluating walking capacity and treatment effect in patients with peripheral arterial disease (PAD). However, self reported functional disability is important when assessing quality of life. Changes in the Walking Estimated Limitation Calculated by History (WELCH) questionnaire scores were compared with the MWT.</AbstractText>
<AbstractText Label="METHODS">A cross sectional study was performed in patients with intermittent claudication. The treadmill test (3.2 km/h; 10% gradient) and WELCH questionnaire were administered to all patients for objective evaluation of walking capacity. Given the log normal distribution of these parameters in patients with PAD, a log transformation was applied to the WELCH score (LnW) and maximum walking time (LnT). The responsiveness of the WELCH score was determined using mean changes and correlation coefficients of LnW and LnT changes. The effect of time on the "estimated minus real" (E - R) changes (LnW - change minus LnT - change) was assessed after categorisation of patients into various test-retest intervals. Patients who underwent lower limb revascularisation between the two tests and those who underwent medical treatment only were analysed.</AbstractText>
<AbstractText Label="RESULTS">Correlation coefficients between LnW and LnT for tests 1 and 2 were r = 0.514 and r = 0.503, respectively (p < .001, for both). Correlation for LnW change vs. LnT change was 0.384 (p < .001). E - R was positive only early after surgery. E - R was negative for all test-retest intervals >1 year in revascularised and non-revascularised patients.</AbstractText>
<AbstractText Label="CONCLUSION">Changes in WELCH scores correlated with changes observed on the treadmill in patients with intermittent claudication. For long test-retest intervals, WELCH changes tended to overestimate the worsening of walking impairment as compared with the measured difference observed in both revascularised and non-revascularised patients. A shortlived "honeymoon" (overestimation of the benefit for the shortest test-retest interval) was observed only in revascularised patients.</AbstractText>
<CopyrightInformation>Copyright © 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Henni</LastName>
<ForeName>Samir</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>Vascular Medicine Department, University Hospital Centre of Angers, Angers, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Ammi</LastName>
<ForeName>Myriam</ForeName>
<Initials>M</Initials>
<AffiliationInfo>
<Affiliation>Vascular Surgery Department, University Hospital Centre of Angers, Angers, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Semporé</LastName>
<ForeName>Yves</ForeName>
<Initials>Y</Initials>
<AffiliationInfo>
<Affiliation>Laboratoire de Physiologie, Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Hersant</LastName>
<ForeName>Jeanne</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>Vascular Medicine Department, University Hospital Centre of Angers, Angers, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Zegar</LastName>
<ForeName>Geoffrey</ForeName>
<Initials>G</Initials>
<AffiliationInfo>
<Affiliation>Vascular Medicine Department, University Hospital Centre of Angers, Angers, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Gourdier</LastName>
<ForeName>Anne-Sophie</ForeName>
<Initials>AS</Initials>
<AffiliationInfo>
<Affiliation>Vascular Medicine Department, University Hospital Centre of Angers, Angers, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Picquet</LastName>
<ForeName>Jean</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>Vascular Surgery Department, University Hospital Centre of Angers, Angers, France; UMR CNRS 6015, INSERM U1083, Mitovasc Institute, Angers, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Abraham</LastName>
<ForeName>Pierre</ForeName>
<Initials>P</Initials>
<AffiliationInfo>
<Affiliation>Vascular Surgery Department, University Hospital Centre of Angers, Angers, France; UMR CNRS 6015, INSERM U1083, Mitovasc Institute, Angers, France. Electronic address: piabraham@chu-angers.fr.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList>
<PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic">
<Year>2019</Year>
<Month>04</Month>
<Day>11</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo>
<Country>England</Country>
<MedlineTA>Eur J Vasc Endovasc Surg</MedlineTA>
<NlmUniqueID>9512728</NlmUniqueID>
<ISSNLinking>1078-5884</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList>
<MeshHeading>
<DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000072700" MajorTopicYN="Y">Conservative Treatment</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000078331" MajorTopicYN="N">Correlation of Data</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D004185" MajorTopicYN="N">Disability Evaluation</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005080" MajorTopicYN="N">Exercise Test</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D017079" MajorTopicYN="N">Exercise Tolerance</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D007383" MajorTopicYN="Y">Intermittent Claudication</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D017063" MajorTopicYN="N">Outcome Assessment, Health Care</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D058729" MajorTopicYN="N">Peripheral Arterial Disease</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011788" MajorTopicYN="Y">Quality of Life</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011795" MajorTopicYN="Y">Surveys and Questionnaires</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D014656" MajorTopicYN="Y">Vascular Surgical Procedures</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D016138" MajorTopicYN="Y">Walking</DescriptorName>
<QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="Y">Peripheral artery disease</Keyword>
<Keyword MajorTopicYN="Y">Questionnaire</Keyword>
<Keyword MajorTopicYN="Y">Revascularisation</Keyword>
<Keyword MajorTopicYN="Y">Treadmill test</Keyword>
<Keyword MajorTopicYN="Y">Walking impairment</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData>
<History>
<PubMedPubDate PubStatus="received">
<Year>2018</Year>
<Month>09</Month>
<Day>25</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted">
<Year>2018</Year>
<Month>11</Month>
<Day>22</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed">
<Year>2019</Year>
<Month>4</Month>
<Day>16</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline">
<Year>2019</Year>
<Month>6</Month>
<Day>5</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez">
<Year>2019</Year>
<Month>4</Month>
<Day>16</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList>
<ArticleId IdType="pubmed">30982731</ArticleId>
<ArticleId IdType="pii">S1078-5884(18)30864-5</ArticleId>
<ArticleId IdType="doi">10.1016/j.ejvs.2018.11.015</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations>
<list>
<country>
<li>Burkina Faso</li>
<li>France</li>
</country>
<region>
<li>Pays de la Loire</li>
</region>
<settlement>
<li>Angers</li>
</settlement>
</list>
<tree>
<country name="France">
<region name="Pays de la Loire">
<name sortKey="Henni, Samir" sort="Henni, Samir" uniqKey="Henni S" first="Samir" last="Henni">Samir Henni</name>
</region>
<name sortKey="Abraham, Pierre" sort="Abraham, Pierre" uniqKey="Abraham P" first="Pierre" last="Abraham">Pierre Abraham</name>
<name sortKey="Ammi, Myriam" sort="Ammi, Myriam" uniqKey="Ammi M" first="Myriam" last="Ammi">Myriam Ammi</name>
<name sortKey="Gourdier, Anne Sophie" sort="Gourdier, Anne Sophie" uniqKey="Gourdier A" first="Anne-Sophie" last="Gourdier">Anne-Sophie Gourdier</name>
<name sortKey="Hersant, Jeanne" sort="Hersant, Jeanne" uniqKey="Hersant J" first="Jeanne" last="Hersant">Jeanne Hersant</name>
<name sortKey="Picquet, Jean" sort="Picquet, Jean" uniqKey="Picquet J" first="Jean" last="Picquet">Jean Picquet</name>
<name sortKey="Zegar, Geoffrey" sort="Zegar, Geoffrey" uniqKey="Zegar G" first="Geoffrey" last="Zegar">Geoffrey Zegar</name>
</country>
<country name="Burkina Faso">
<noRegion>
<name sortKey="Sempore, Yves" sort="Sempore, Yves" uniqKey="Sempore Y" first="Yves" last="Semporé">Yves Semporé</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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