Validation of a Treadmill Walking Test to Discriminate Neurogenic Claudication From Vascular Claudication

Université du Québec à Trois-Rivières

Status: Completed

Conditions: Spinal Stenosis Lumbar; Claudication; Peripheral Artery Disease; Low Back Pain

Treatments: Diagnostic Test: Treadmill walking test

Study type: Observational

Funder types: Other

Identifiers

NCT04058171

UQTR-2017-claudication

Details and patient eligibility

About

The first aim of this study was to elaborate and validate a treadmill walking test that would help discriminate between neurogenic claudication from vascular claudication. The second objective of this study is to determine if the treadmill walking test can discriminate spinal stenosis from low back pain with radiating pain in lower limb.

Full description

To date, an important challenge that clinicians hare facing in the assessment and diagnosis of intermittent claudication is that pathologies associated with vascular or neurogenic claudication can coexist in the same patient. Differentiation between both origins can be difficult due to variable signs and symptoms which can be atypical.

The first aim of this study was to elaborate and validate a treadmill walking test that would help discriminate between neurogenic claudication from vascular claudication. The second objective of this study is to determine if the treadmill walking test can discriminate spinal stenosis from low back pain with radiating pain in lower limb. 60 participants (20 with spinal stenosis, 20 with peripheral artery disease and 20 with non-specific low back pain) will be recruited. Participants will be invited to walk on a treadmill at a speed of 1,2 mph for a maximum of five minutes for both tasks (straight walking posture and inclined walking posture). Each walking task will be followed by a rest time of five minutes in sitting position. It is hypothesized that walking time difference for the occurrence of pain and for pain relief will be sensitive and specific to pathologies and help to discriminate lumbar spinal stenosis.

Enrollment: 55 patients

Sex: All

Ages: 40+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Lumbar spinal stenosis (LSS) group :

• Central stenosis
• Pain in at least one leg
• Neurological signs in the lower limbs (numbness or tingling)
• Weaknesses in the lower limb
• Pain relieved by sitting or bending the trunk

Peripheral artery disease (PAD) group :

• Claudication while walking
• Ankle-brachial index < 0.9
• Pain relieved by rest

Low back pain (LBP) :

• Pain radiating in the lower limb
• Weaknesses
• Pain relieved by sitting

Exclusion criteria

• Foraminal stenosis
• Spinal stenosis with predominant back pain
• Symptomatic disc herniation
• Previous lumbar surgery
• Previous vascular surgery
• Type 1 diabetes
• Knee or hip osteoarthritis
• Hip or knee arthroplasty
• Inability to provide free and informed consent

Trial design

55 participants in 3 patient groups

LSS group

Description:

Participants with a diagnosis of lumbar spinal stenosis

Treatment:

Diagnostic Test: Treadmill walking test

PAD group

Description:

Participants with a diagnosis of peripheral artery disease

Treatment:

Diagnostic Test: Treadmill walking test

LBP group

Description:

Participants with a diagnosis of non specific low back pain

Treatment:

Diagnostic Test: Treadmill walking test