Plantar flexion as an alternative to treadmill exercise for evaluating patients with intermittent claudication.

Abstract

The aim of this study was to examine whether the plantar flexion test could adequately replace treadmill testing in patients who were unable to exercise. Prospective observational study. Twenty-seven patients with intermittent claudication secondary to peripheral arterial disease (PAD). Patients performed two treadmill tests and two plantar flexion tests. Ankle pressure, near infrared spectroscopy (NIRS) data, heart rate and blood pressures were monitored along with pain-free and maximum walking distances for treadmill, pain-free and maximum exercise time for plantar flexion. Maximum exercise time and walking distance were well correlated (R=0.74). Eleven patients (41%) developed non-claudicating symptoms during the treadmill test but not during the flexion test. Rate pressure product was significantly higher after the treadmill but not after the plantar flexion. Plantar flexion test showed good reliability and correlation. Plantar flexion may serve as an alternative to treadmill testing in evaluating muscle pain in patients with intermittent claudication.