POOR REPRODUCIBILITY OF EXERCISE TEST IN ASSESSMENT OF CLAUDICATION

To assess reproducibility of the exercise test in intermittent claudic ation, a prospective, comparative, randomized study was undertaken. Te n patients with stable intermittent claudication of ischaemic origin w ere exercised on a flat surface (0-Ex), with 12% steady inclination (1 2-Ex) and with progressively increasing inclination (p-Ex) in a random order during three different sessions. The ankle-brachial index (ABI) at rest and after exercise (rABI, exLBI), initial and maximum walking distance (IWD, MWD) and metabolic equivalent (MET) were obtained as t he main outcome measures. The results were analysed using intraindivid ual coefficients of variation (CVs) and standard deviations (SDs). The ABI values of the worst extremity were used in evaluation of results. Reproducibility of the exercise ABI appeared to be good, especially d uring progressively increasing exercise, the mean CV being 9 +/- 5%. T he best mean CV was observed during p-Ex (16% +/- 14%) for maximum wal king distance. The mean CV for initial walking distances ranged from 3 0% to 54%. Treadmill exercise testing to measure walking distances is highly inaccurate and the value of exercise on the flat treadmill shou ld be questioned. Graded exercise appeared to be the most reproducible in this respect. The ABI after exercise, however, was a reliable sing le parameter when assessing arterial insufficiency causing decreased w alking capacity.