Clinical Characteristics and Rehabilitative Therapeutic Effect on Peripheral Arterial Disease Combined with Lumbar Spinal Stenosis.

, Kim, Chul; , Lee, Dong Woo; , Park, Yong Bum

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2011;35(2):250-258.

Kim, Chul , Lee, Dong Woo , Park, Yong Bum

Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 139-707, Korea. swc328@naver.com

Abstract

Objective
To access the clinical features of peripheral arterial disease (PAD) combined with lumbar spinal stenosis (LSS) in patients, and the effects of peripheral arterial disease rehabilitation after peripheral vascular intervention. Method We studied 21 patients who were diagnosed with PAD combined with LSS. We investigated the past histories symptoms, diagnoses and treatment of the 21 patients to determine if there were atypical features that could be attributed to PAD. Thirteen patients who were diagnosed with PAD combined with LSS received peripheral arterial disease rehabilitation after peripheral vascular intervention. A control group (n=11) was instructed to practice self- exercise training in the community exercise program after peripheral vascular intervention. Initial claudication distance (ICD), absolute claudication distance (ACD), peak oxygen uptake, and ankle-brachial index (ABI) were measured at baseline, 3 months, and 6 months after peripheral arterial disease rehabilitation.
Results
Thirteen of 16 patients were satisfied with the cardiac rehabilitation program and experienced symptom relief, however, there was a recurrence of symptoms and peripheral arterial restenosis in 2 patients. After peripheral arterial disease rehabilitation, PAD and LSS groups showed significant changes in ABI, ICD, ACD, and peak oxygen uptake. The control group also showed significant improvements of ABI, ICD, ACD, and peak oxygen uptake. There were significant differences between the two groups in ICD, ACD, and peak oxygen uptake after 6 months. Conclusion Attention should be paid to patients complaining of back pain, lower limb radiating pain, and claudication, because they were diagnosed with neurogenic intermittent claudication by simple spinal stenosis and it would overlook the PAD. We recommend also considering the possibility of PAD. Compared with angioplasty alone, angioplasty in combination with subsequent training is a superior treatment modality for patients with intermittent claudication.

Key Words: Peripheral arterial disease, Spinal stenosis, Rehabilitation