The "Walking Estimated Limitation Stated by History" (WELSH) visual tool is applicable and accurate to determine walking capacity, even in people with low literacy level.

Determination of the self-reported walking capacity by interview or standardized questionnaire is important. However, the existing questionnaires require the patient to be able to read and write in a specific language. We recently proposed the WELSH (Walking Estimated Limitation Stated by History) tool to be administrable to illiterate people.

Exercise-Induced Plasma Metabolomic Profiles in Patients With Peripheral Arterial Disease.

A better knowledge of the biological consequences in the blood of these exercise-induced ischemic events in lower extremity artery disease (LEAD) may improve the prospects of disease management. We explored the preminus postexercise metabolomic difference in 39 patients with LEAD referred for a treadmill oximetry test [transcutaneous oximetry (TcPO)]. Ischemia was estimated through the sum of decrease from rest of oxygen pressure (DROPs) (limb TcPO changes minus chest TcPO changes) at buttocks, thighs, and calves regions.

The hidden side of calf claudication: Hemodynamic and clinical results of treadmill testing in 584 patients complaining of isolated exertional calf pain.

Background And Aims: Calf pain is the most frequent symptom of arterial claudication. We hypothesized that patients with self-reported isolated calf claudication have frequent exertional non-calf symptoms during objective laboratory testing, and that many would show not only distal, but also proximal ischemia.

Methods: We retrospectively analyzed the patients referred since 2016 for exercise transcutaneous oxygen pressure (Ex-tcpO).

The walking estimated limitation stated by history (WELSH): a visual tool to self-reported walking impairment in a predominantly illiterate population.

Background: The prevalence of cardiovascular diseases is increasing in low-income countries. Various questionnaires to estimate walking capacity in patients are available in multiple languages but they are not suitable for illiterate patients.

Objective: The walking estimated limitation stated by history (WELSH) tool aims at rating individual walking disability using only drawings and four items.

Clinical application of transcutaneous oxygen pressure measurements during exercise.

Exertional lower limb pain is a frequent diagnostic issue in elderly patients. Arterial claudication results from the mismatch between the oxygen requirement of, and oxygen delivery to the exercising muscles. Non-invasive vascular investigations (ultrasound imaging, plethysmography or segmental pressure) are used in routine at rest or following exercise, but none can be used during walking or to directly monitor cutaneous oxygen delivery to the limb.

Multiprobe devices for exercise transcutaneous oxymetry in patients complaining claudication: interest and limits of unusual probe positions.

Background: Exercise transcutaneous oximetry (PtcO2) can argue for a vascular origin of exercise-related pain in atypical unusual localizations, such as lumbar, thigh or foot pain. We used five probes as a standard for treadmill PtcO2 tests. Recent commercially available devices now include up to eight probes.

The correlation of the "Walking Estimated-Limitation Calculated by History" (WELCH) questionnaire with treadmill maximal walking time is not impaired by age, in patients with claudication.

Purpose: The "Walking Estimated-Limitation Calculated by History" (WELCH) questionnaire is a short four-item questionnaire that estimates the walking capacity of a patient in comparison with relatives, friends or people the same age. As such, it should be relatively insensitive to age, yet this has never been tested.

Methods: A prospective study was performed among 525 patients presenting vascular-type claudication.

Validation of the English version of the Walking Estimated-Limitation Calculated by History (WELCH) questionnaire in patients with intermittent claudication.

The Walking Estimated-Limitation Calculated by History (WELCH) questionnaire has recently been proposed as a valid and simple instrument for assessing walking limitation in patients with intermittent claudication. The aim of this study was to validate an English version of the WELCH questionnaire in an English native population. Thirty-nine patients (ankle-brachial index 0.

Development and evaluation of the Walking Estimated-Limitation Calculated by History questionnaire in patients with claudication.

Background: The Walking Impairment Questionnaire (WIQ) is used to estimate walking impairment in patients with peripheral artery disease; however, it faces frequent errors when self-completed and is complex to score. We aimed to validate an alternative, easily scored four-item tool, the Walking Estimated-Limitation Calculated by History (WELCH) questionnaire.

Methods: The WIQ and WELCH were prospectively tested in five centers.

Proximal ischemia is a frequent cause of exercise-induced pain in patients with a normal ankle to brachial index at rest.

Background: Excluding a vascular origin of exercise-related pain is often difficult in clinical practice. Recent papers have underlined the frequent association of concurrent lumbar spine degenerative disease and peripheral arterial disease. Furthermore, even when suspected, isolated exercise-induced proximal ischemia is difficult to diagnose.

Calf muscle stimulation with the Veinoplus device results in a significant increase in lower limb inflow without generating limb ischemia or pain in patients with peripheral artery disease.

Objective: Increase in arterial inflow to the lower limbs is important to obtain functional improvement in peripheral artery disease (PAD) patients with claudication. The aim of this study was to assess the effect of electrical stimulation of calf muscles on arterial inflow and tissue oxygen content in PAD in the area of stimulation.

Methods: Fifteen adult patients [mean (standard deviation) age, 62 (12 ) years; height, 165 (8)cm; weight, 76 (13) kg; lowest ankle-brachial index 0.

Aging reduces the accuracy of self-reported walking limitation in patients with vascular-type claudication.

Background: The published correlations between treadmill performance and the Walking Impairment Questionnaire (WIQ) score are generally fair. We hypothesized that the slope of the relationship of maximal treadmill walking time to WIQ would be lower in older than in younger patients, resulting in (1) a fair correlation in the population considered as a whole and (2) different cutoff points of the WIQ score to predict the ability to complete 5 minutes of treadmill walking in different age groups.

Methods: A 9-month prospective study was performed among patients referred for vascular-type claudication.

Impaired somatosensation in patients with isolated proximal-without-distal exercise-related lower-limb ischemia.

Objectives: Isolated proximal-without-distal (buttock but not calf) exercise-related lower-limb ischemia (IPI) might develop in the presence of arterial lesions impairing the blood flow supply toward the hypogastric vascular bed. In IPI, lower-limb sensory nerve dysfunction might occur from the sacral nerve plexus becoming ischemic during exercise. The purpose of this study was to compare patients with IPI with healthy controls for the presence of sensory nerve dysfunction, as assessed using somatosensory testing (SST).

Self-reported estimation of usual walking speed improves the performance of questionnaires estimating walking capacity in patients with vascular-type claudication.

Objective: Most questionnaires do not estimate the usual walking speed of the patient, although it is well known that patients may experience apparently different walking capacities if walking slow or fast. We hypothesized that correcting the self-reported estimated walking capacity by a coefficient issued from the self-reported estimation of usual walking speed would significantly improve the correlation between questionnaire-estimated and treadmill-measured walking capacity.

Methods: Three hundred ten consecutive patients complaining of vascular-type claudication were asked to estimate their usual walking speed in comparison to people of their age (or friends or relatives) with ratings ranging from much slower (1 pt) to much faster (5 pts), in addition to the filling out of the walking impairment questionnaire (WIQ) and the estimated ambulatory capacity by history questionnaire (EACH-Q).

Validation of a new simple questionnaire to "estimate ambulation capacity by history" (EACH) in patients with claudication.

Objectives: The assessment of walking limitation is important in determining the severity of many diseases, including peripheral artery disease. Questionnaires exist for estimating walking capacity, but these have limited use in routine clinical practice. We sought to establish the feasibility and validity of the estimating ambulation capacity by history questionnaire (EACH-Q), a self-administered, four-item questionnaire that estimates walking capacity in patients reporting vascular-type claudication.

Heart rate recovery after constant-load exercise tests is decreased in proportion to the importance (severity and diffusion) of exercise-induced lower-limb ischaemia.

Background: Conditions that may influence heart rate recovery at 1 min of recovery from exercise (HRR1: end-exercise heart rate minus heart rate 1 min after exercise) are not fully understood. We hypothesized that the 'importance' (both local severity and regional diffusion) of peripheral skeletal muscle ischaemia is associated with low HRR1.

Design And Methods: In 529 patients with suspected or confirmed peripheral vascular disease not receiving beta-blockers (61·4 ± 11·3 years old), we retrospectively studied the relationship of HRR1 to exercise-induced changes in transcutaneous oxygen DROP index (limb changes minus chest changes from rest).