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ABSTRACT
The purposes of this study were to determine the relationship between the physical activity values obtained from the peripheral arterial disease-physical activity recall (PAD-PAR) questionnaire and (1) the free-living daily physical activity obtained from the doubly labeled water technique and (2) clinical measures of PAD severity. Fifty-one older PAD patients age=70+/-6 years) were recruited from the Vascular Clinic at the Baltimore Veterans Affairs Medical Center and from radio and newspaper advertisements. Energy expenditure of physical activity EEPA) was determined by using doubly labeled water and indirect calorimetry techniques. PAD severity was measured by ankle/brachial index (ABI) and walking distance to maximal claudication pain determined during a graded treadmill test. In addition, patients were also characterized on body composition and total daily energy expenditure. The physical activity values obtained from the PAD-PAR questionnaire (113+/-37 MET-hr/wk) were not related to EEPA (542+/-260 kcal/day; r= -0.057, p=0.690), ABI (0.64+/-0.19; r=0.032, p=0.826); or distance to maximal claudication pain (376+/-229 m; r=-0.054, p=0.731). The authors conclude that the PAD-PAR questionnaire is not an accurate measurement of free-living daily physical activity when compared to EEPA by use of the criterion method of doubly labeled water, and the activity questionnaire measures were poorly correlated with clinical measures of PAD severity.
Introduction
The primary symptom of peripheral arterial disease (PAD) is intermittent claudication,1,2 which impairs ambulatory ability and lowers functional capacity.3,4 Additionally, intermittent claudication limits the number and amount of activities of daily living that can be performed.4 This leads to a sedentary lifestyle, which may ultimately increase the risk for further progression of cardiovascular disease and the occurrence of cardiovascular related events. Consequently, physical activity is an important variable to consider in PAD patients with intermittent claudication because of its potential role in subsequent cardiovascular disease morbidity and mortality.
The peripheral arterial disease-physical activity recall (PAD-PAR) questionnaire has been developed and recommended5,6 to quantify the weekly physical activity level of patients with intermittent claudication. However, the validity of the PAD-PAR questionnaire has not been rigorously tested by comparing it to the physical activity measurements obtained from the doubly labeled water technique, the gold standard measure of the energy expenditure of physical activity.7 Furthermore, the relationship between the activity values obtained from the PAD-PAR questionnaire with functional and hemodynamic...