Objective assessment of functional capacity in patients with peripheral artery disease: a narrative review

ABSTRACT

Introduction

Peripheral artery disease (PAD) patients with claudication symptoms exhibit impaired functional capacity, which has been associated with disease severity, worse quality of life and higher risk of cardiovascular events. Different tests have been used to assess functional capacity in PAD patients. Therefore, understanding the characteristics, strengths and limitations of these tests are important to support the choice of tests to be used in clinical practice.

Areas covered

This review summarizes the main methods to assess functional capacity in PAD patients, discussing their psychometric properties, applications, and limitations.

Expert opinion

Robust evidence supports the use of treadmill and six-minute walk tests in PAD patients, as their results are associated with clinically meaningful outcomes, adequate psychometric properties and are sensitive to effects of interventions. On the other hand, other functional tests (Shuttle-walk test, outdoor walking capacity test, timed-up and go, four-meter walk test, heel-rise test, short physical performance battery and modified physical performance battery) are related to activities of daily living and do not require sophisticated equipment and can be easily used in clinical practice. However, these other tests still need evidence regarding their clinical relevance, reliability, and ability to detect long-term intervention changes, providing further investigation directions.

KEYWORDS:

• Cardiovascular disease
• functional tests
• intermittent claudication
• six-minute walk test
• walking

Article highlights

• Peripheral artery disease (PAD) patients present impaired functional capacity, that is related to higher risk of cardiovascular events.

• Many functional tests have been used to measure functional capacity in this population.

• Thus, understanding the characteristics, strengths and limitations of these tests are important to support the choice of tests to be used in clinical practice.

• There is robust evidence supporting the use of treadmill and six-minute walk tests in PAD patients, but other functional tests are of good quality, are related to activities of daily living and do not require sophisticated equipment.

• However, these other tests still need further investigation on their clinical relevance, reliability, and ability to detect changes to long-term interventions.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This work was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (process#88887.818156/2022-00).