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(Circulation. 2008;117:897-904.)
© 2008 American Heart Association, Inc.

Exercise Physiology

Measurement of Walking Distance and Speed in Patients With Peripheral Arterial Disease

A Novel Method Using a Global Positioning System

Alexis Le Faucheur, PhD; Pierre Abraham, PhD, MD; Vincent Jaquinandi, MD; Philippe Bouyé, PhD, MD; Jean Louis Saumet, PhD, MD; Bénédicte Noury-Desvaux, PhD

From the Laboratory of Physiology (A.L.F., P.A., J.L.S.), CNRS, UMR6214, INSERM U771, Medical School, University of Angers, and Laboratory for Vascular Investigations (P.A., V.J., P.B., J.L.S.). University Hospital, Angers, France; and Institute of Physical Education and Sports Sciences (IFEPSA; B.N.-D.), UCO, Les ponts de Cé, France.

Correspondence to Dr Pierre Abraham, Laboratory for Vascular Investigations, University Hospital, 4 rue Larrey, Angers Cedex, 09, F-49033 France. E-mail Piabraham{at}chu-angers.fr

Received July 12, 2007; accepted December 14, 2007.

Background— The maximal walking distance (MWD) performed on a treadmill test remains the "gold standard" in estimating the walking capacity of patients who have peripheral arterial disease with intermittent claudication, although treadmills are not accessible to most physicians. We hypothesized that global positioning system (GPS) recordings could monitor community-based outdoor walking and provide valid information on walking capacity in patients with peripheral arterial disease.

Methods and Results— We studied 24 patients (6 women) with arterial claudication (median [25th to 75th percentile] values: 57 years old [48 to 67 years], 169 cm tall [164 to 172 cm], weight 81 kg [71 to 86 kg], and ankle-brachial index 0.64 [0.56 to 0.74]). MWD on the treadmill was 184 m (144 to 246 m), which was compared with the results of self-reported MWD, the distance score from the Walking Impairment Questionnaire, MWD observed during a 6-minute walking test, and MWD measured over a GPS-recorded unconstrained outdoor walk in a public park. Self-reported MWD, Walking Impairment Questionnaire distance score, 6-minute walking test score, and GPS-measured MWD were 300 m (163 to 500 m), 28% (15% to 47%), 405 m (338 to 441 m), and 609 m (283 to 1287 m), respectively. The best correlation with MWD on the treadmill test was obtained with the MWD measured by the GPS (Spearman r=0.81, P<0.001).

Conclusions— Outdoor walking capacity measured by a low-cost GPS is a potentially innovative way to study the walking capacity of patients with peripheral arterial disease. It opens new perspectives in the study of walking capacity for vascular patients with claudication under free-living conditions or for physicians who do not have a treadmill.

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CLINICAL PERSPECTIVE

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Clinical Summaries
Circulation 2008 117: 857-859. [Full Text]