Rev. DERC (Online) 2019; 25(3): 75-79
CONTRIBUTION OF EXERCISE TESTING IN THE EVALUATION OF PERIPHERAL OBSTRUCTIVE ARTERIAL DISEASE
ABSTRACT
Peripheral obstructive arterial disease is the third leading cause in the world of atherosclerotic cardiovascular morbidity. About 70% to 80% of affected patients are asymptomatic, which may delay or hinder early diagnosis. Intermittent claudication is the most common symptom. The main risk factors associated with the disease are advanced age, high blood pressure, diabetes mellitus, dyslipidemia and smoking. The ankle-brachial index is considered the main clinical test to diagnose the presence and severity of the disease, regardless of the symptoms presented by the patient. Simple forms of functional assessment include the six-minute walk test and the four-meter gait speed test. The technical ease of application by the investigator as well as simple execution for the patient are the main advantages of the walking test. However, the possibility of environmental and psychological influences may favor submaximal results and interpretations not consistent with the actual functional state. In turn, the treadmill exercise test is recommended to provide objective evidence of the magnitude of functional limitation of lameness and to measure response to therapy. It is recommended to use a standardized exercise protocol (fixed or progressive load). Studies that include treadmill testing for functional and prognostic assessment have more robust data compared with walking tests. Additionally, they are more accurate for broader cardiovascular assessment.
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