Quality of Life in Patients with Intermittent Claudication: Relationship with Laboratory Exercise Performance

In patients with peripheral arterial disease, limitation of exercise capacity will reduce the level of everyday physical activity and affect the quality of life. This study was designed (1) to examine the health-related quality of life of patients with intermittent claudication, and (2) to verify whether treadmill performance is related to the patient's perceived ability to function in the community. In 251 patients with intermittent claudication and 89 matched normal subjects, quality of life was assessed by a general health index questionnaire, the McMaster Health Index Questionnaire (MHIQ), which covers three dimensions of life (physical, social and emotional function). The maximal walking capacity of intermittent claudication patients was measured by the treadmill test. When controls were compared to intermittent claudication patients using the MHIQ, it was found that intermittent claudication patients showed a significant (p<0.01) impairment of ‘general health’ and lower scores for physical (0.90±0.17 vs 0.65±0.17; p<0.01), social (0.71±0.11 vs 0.63±0.12; p<0.01) and emotional (0.75±0.17 vs 0.65±0.15; p<0.01) function. Age, gender and work status had a significant impact upon health scores in several areas. Treadmill performance did not correlate with social or emotional function, whereas there was a small but significant relationship between maximal walking capacity and physical function scores (r=0.197; p<0.01). This study suggests that impairment in quality of life experience by patients with intermittent claudication poorly correlates with the reduced exercised capacity assessed by the treadmill test. Therefore, the evaluation of medical and surgical treatment of intermittent claudication should include the administration of a questionnaire for quality of life assessment.

[1]  P. Waller,et al.  Pharmacological Approaches to the Treatment of Intermittent Claudication , 1992, Drugs & aging.

[2]  M. Hunink,et al.  The use of angioplasty, bypass surgery, and amputation in the management of peripheral vascular disease. , 1992, The New England journal of medicine.

[3]  J. D. Coffman Intermittent claudication--be conservative. , 1991, The New England journal of medicine.

[4]  J. Cronenwett,et al.  Basic data related to the natural history of intermittent claudication , 1989, Annals of vascular surgery.

[5]  G. Guyatt,et al.  Measuring quality of life in clinical trials: a taxonomy and review. , 1989, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[6]  S Greenfield,et al.  The state of outcome research: are we on target? , 1989, The New England journal of medicine.

[7]  S. Greenfield,et al.  The Medical Outcomes Study. An application of methods for monitoring the results of medical care. , 1989, JAMA.

[8]  M. Bousser,et al.  Fate of the patient with chronic leg ischaemia. A review article. , 1989, The Journal of cardiovascular surgery.

[9]  J. Regensteiner,et al.  The Evaluation of Exercise Performance in Patients with Peripheral Vascular Disease , 1988 .

[10]  P. Waller,et al.  Drug treatment of intermittent claudication: a critical analysis of the methods and findings of published clinical trials, 1965-1985. , 1988, British journal of clinical pharmacology.

[11]  J. Morris,et al.  Quality of life of cancer patients at different stages in the disease trajectory. , 1987, Journal of chronic diseases.

[12]  G. Klerman,et al.  The effects of antihypertensive therapy on the quality of life. , 1986, The New England journal of medicine.

[13]  G H Guyatt,et al.  How should we measure function in patients with chronic heart and lung disease? , 1985, Journal of chronic diseases.

[14]  G. Prigatano,et al.  Quality of life and its predictors in patients with mild hypoxemia and chronic obstructive pulmonary disease. , 1984, Archives of internal medicine.

[15]  R. Deyo,et al.  Measuring Functional Outcomes in Chronic Disease: A Comparison of Traditional Scales and a Self- Administered Health Status Questionnaire in Patients With Rheumatoid Arthritis , 1983, Medical care.

[16]  L. Chambers,et al.  The McMaster Health Index Questionnaire as a measure of quality of life for patients with rheumatoid disease. , 1982, The Journal of rheumatology.

[17]  E F Cook,et al.  Comparative Reproducibility and Validity of Systems for Assessing Cardiovascular Functional Class: Advantages of a New Specific Activity Scale , 1981, Circulation.

[18]  J. Brown,et al.  Life Satisfaction and Chronic Disease: Exploration of a Theoretical Model , 1981, Medical care.

[19]  M. Bergner,et al.  The Sickness Impact Profile: Development and Final Revision of a Health Status Measure , 1981, Medical care.

[20]  E M Backett,et al.  A quantitative approach to perceived health status: a validation study. , 1980, Journal of epidemiology and community health.

[21]  L. Chambers,et al.  The development and application of indices of health: general methods and a summary of results. , 1977, American journal of public health.

[22]  F. Fortin,et al.  Validation of Questionnaires on Physical Function , 1977, Nursing research.

[23]  Gary R Lichtenstein [Letter to the Editor] , 1996, Nature.