Exploring the relationship between ankle strength and endurance factors and the severity and level of ischemia in patients with peripheral arterial disease

Abstract

Background: Peripheral Arterial Disease (PAD) is a global health concern, particularly among aging populations. While previous studies have examined various aspects of PAD, the role of ankle muscle strength and endurance in assessing ischemia severity remains underexplored. This study investigates the relationship between ankle dorsiflexion and plantar flexion strength and ischemia severity in PAD patients.

Methods: This cross-sectional observational study included 53 PAD patients with chronic limb ischemia confirmed via angiography. Mean age was 64.5 years, and the majority were male. Ankle muscle strength was measured using a custom-designed hand-held dynamometer, which underwent internal validation and reliability testing before implementation. Spearman's correlation and multiple regression models assessed the association between muscle function and ischemia severity.

Results: A significant positive correlation was found between dorsiflexion/plantar flexion strength and ischemia severity one-month post-intervention (Spearman's rho = 0.35, P = 0.015; Spearman's rho = 0.40, P = 0.010). Pre-intervention assessments established a baseline correlation, allowing evaluation of ischemia progression and its impact on muscle function.

Conclusion: Our data showed that ankle strength assessments may serve as predictive markers for ischemia severity in PAD patients. Implementing these measurements in clinical practice could enhance treatment optimization and patient outcomes.

Keywords: Chronic limb ischemia; Dynamometry; Functional outcomes; Ischemia severity; Muscle strength assessment; Peripheral arterial disease (PAD); Predictive markers; Treatment optimization.