Global Positioning System Use in the Community to Evaluate Improvements in Walking After Revascularization: A Prospective Multicenter Study With 6-Month Follow-Up in Patients With Peripheral Arterial Disease

Revascularization aims at improving walking ability in patients with arterial claudication. The highest measured distance between 2 stops (highest-MD(CW)), the average walking speed (average-WS(CW)), and the average stop duration (average-DS(CW)) can be measured by global positioning system, but their evolution after revascularization is unknown. We included 251 peripheral artery diseased patients with self-reported limiting claudication. The patients performed a 1-hour stroll, recorded by a global positioning system receiver. Patients (n = 172) with confirmed limitation (highest-MD(CW) <2000m) at inclusion were reevaluated after 6 months. Patients revascularized during the follow-up period were compared with reference patients (ie, with unchanged lifestyle medical or surgical status). Other patients (lost to follow-up or treatment change) were excluded (n = 89). We studied 44 revascularized and 39 reference patients. Changes in highest-MD(CW) (+442 vs. +13 m) and average-WS(CW) (+0.3 vs. −0.2 km h(−1)) were greater in revascularized than in reference patients (both P < 0.01). In contrast, no significant difference in average-DS(CW) changes was found between the groups. Among the revascularized patients, 13 (29.5%) had a change in average-WS(CW), but not in highest-MD(CW), greater than the mean + 1 standard deviation of the change observed for reference patients. Revascularization may improve highest-MD(CW) and/or average-WS(CW). This first report of changes in community walking ability in revascularized patients suggests that, beyond measuring walking distances, average-WS(CW) measurement is essential to monitor these changes. Applicability to other surgical populations remains to be evaluated. Registration: http://www.clinicaltrials.gov/ct2/show/NCT01141361