The calf muscle strength correlation with the severity of ischemia and outcomes in patients with chronic lower limb ischemia

Abstract

Objective

The association between peripheral arterial disease (PAD) as one of the chronic vascular diseases with decreased muscle endurance of the lower limbs has been reported in many studies. This study evaluated the correlation between calf strength measures with disease severity and its outcomes in patients with chronic limb ischemia.

Participants

This study was conducted on 53 patients with chronic limb ischemia referred to the Department of Vascular Surgery Taleghani Hospital, affiliated to Shahid Beheshti University of Medical Sciences between October 2020 and November 2021.

Design

The strength measurements included the dorsiflexion strength (DFS) and plantar flexion strength (PFS) of the affected limbs, which were measured using a newly developed dynamometer. Disease severity evaluated with angiography and outcomes were evaluated in all patients for three months.

Results

The mean age was 64.51 ± 9.3 years. The mean DFS and PFS were 13.55 ± 4.24 kg and 20.1 ± 8.29 kg, respectively. The need for invasive intervention was required in 42 (79.2%) patients. Amputation was performed in 21(39.6%). The multivariate analysis showed chronic limb ischemia severity (B: 7.11, 95% CI: 11.74, −2.46, P: 0.001), involvement level (B: 2.53, 95% CI: 4.03, −1.02, P: 0.042) and outcome type (B: 2.66, 95%CI: 4.22, −1.08, P: 0.039) were significantly related to DFS. The chronic limb ischemia severity (B: 3.89, 95%CI: 6.14, −1.64, P: 0.002) and level of involvement (B: 2.11, 95%CI: 3, −1.01, P:0.047) were significantly associated with PFS.

Conclusion

Our study showed that PFS and DFS were lower in patients with severe forms of chronic limb ischemia and those with simultaneous involvement of both above and below knee. DFS in patients requiring amputation was significantly lower than patients who did not require amputation during three months follow-up.