POLSKI PRZEGLĄD CHIRURGICZNY 10.2478/v10035-008-0022-5 2008, 80, 4, 184–189 EVALUATION OF THE DEPENDENCY BETWEEN THE CLAUDICATION DISTANCE REPORTED BY THE PATIENT AND THE ANKLE-BRACHIAL INDEX AT REST, AND THE DISTANCE COVERED ON THE TREADMILL TEST IN PATIENTS WITH LOWER LIMB ISCHEMIA TOMASZ GRZELA, ARKADIUSZ MIGDALSKI, ARKADIUSZ JAWIEŃ, RADOSŁAW PIOTROWICZ, ARTUR SZOTKIEWICZ Chair and Department of General Surgery, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń Kierownik: prof. dr hab. A. Jawień Views concerning the dependency between the claudication distance and ankle-brachial index values are ambiguous. The aim of the study was to determine the correlation between the distance covered during the tread- mill test and ankle-brachial index, and the distance covered during the treadmill test and claudication distance reported by the patient. Material and method. The study group contained 75 patients of both genders, above the age of 40 years, treated at the Vascular Disease Outpatient Clinic, diagnosed with one or both-sided intermittent claudication, and with an ankle-brachial index below 0.9. In all patients we evaluated the ankle-brachial index at rest, considering both lower limbs, as well as the claudication distance on the treadmill test (3.2 km/h, 12° gradient). We determined the distance traveled until the manifestation of pain (distance free of pain), and the distance until complete stop (total walking distance). Analysis always considered one (the worse) lower limb of the patient. Results. There was no correlation between the ankle-brachial index and distance covered during the treadmill test. However, there was a statistically significant dependency between the claudication di- stance reported by the patient, and that observed during the treadmill test. A moderate correlation was observed between the total walking distance and the claudication distance reported by the patient (r= 0.441, p=0.001). Conclusions. 1. The ankle-brachial index at rest should not be used as a measure of the intensification of lower limb ischemia symptoms in patients with intermittent claudication. 2. The claudication distan- ce reported by the patient only moderately correlates with the total observed walking distance. Key words: ankle-brachial index, total walking distance, intermittent claudication Intermittent claudication is such a charac- teristic and repeatable symptom of chronic lo- wer limb ischemia that it is often possible to establish an initial diagnosis based on this symptom alone. Accurate physical examination and the evaluation of the pulse, as well as an- kle-brachial index measurements, provides confirmation of the diagnosis (1). Further qu- antification of symptoms reported by the pa- tient can be performed during walking efficien- cy trials on a treadmill. The treadmill test ena- bles us to objectively determine the patients’ activity limits, and the standardized protocol provides data allowing for the comparison of walking efficiency in different patients (2). The claudication distance reported by the patient is often an imprecise parameter. In order to better determine the patients’ activity limits, further information is required including the pace of the walk, step distance, and factors in-