Pharmacological Treatment of Intermittent Claudication Does Not Have a Significant Effect on Gait Impairments During Claudication Pain

in Journal of Applied Biomechanics
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Peripheral arterial disease (PAD) is a manifestation of atherosclerosis resulting in intermittent claudication (IC) or leg pain during physical activity. Two drugs (cilostazol and pentoxifylline) are approved for treatment of IC. Our previous work has reported no significant differences in gait biomechanics before and after drug interventions when PAD patients walked without pain. However, it is possible that the drugs are more efficacious during gait with pain. Our aim was to use advanced biomechanical analysis to evaluate the effectiveness of these drugs while walking with pain. Initial and absolute claudication distances, joint kinematics, torques, powers, and gait velocity during the presence of pain were measured from 24 patients before and after 12 weeks of treatment with either cilostazol or pentoxifylline. We found no significant improvements after 12 weeks of treatment with either cilostazol or pentoxifylline on the gait biomechanics of PAD patients during pain. Our findings indicate that the medications cilostazol and pentoxifylline have reduced relevance in the care of gait dysfunction even during pain in patients with PAD.

Jennifer M. Yentes, Jessie M. Huisinga, and Sara A. Myers are with the Nebraska Biomechanics Core Facility, Department of Health, Physical Education, and Recreation, University of Nebraska at Omaha, Omaha, NE. Iraklis I. Pipinos and Jason M. Johanning are with the Department of Surgery, Western Iowa– Nebraska Veterans’ Affairs Healthcare Center and University of Nebraska Medical Center, Omaha, NE. Nicholas Stergiou (Corresponding Author) is with the Nebraska Biomechanics Core Facility, Department of Health, Physical Education, and Recreation, University of Nebraska at Omaha, and with Department of Environmental, Agricultural, and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE.