A prospective comparison of pedal ergometry with conventional treadmill testing in the investigation of lower extremity pain

Background Investigation of lower extremity pain is compromised by comorbid disorders that may interfere with conventional testing. Aims To compare pedal ergometry with conventional treadmill testing. Methods A prospective study was performed where patients presenting with a diagnosis of intermittent claudication were assessed by both methods of tes ting. Results Of 78 patients studied with both tests, no exercise-induced ankle p ressure changes occurred in 26, two were unable to complete either test des pite normal pressure measurements, while 24 had exercise-induced pressure d rop detected by both tests. Of patients who completed pedal ergometry, 21 w ere unable to complete the treadmill test, 14 of whom had negative ergometr y, while seven had a pressure drop detected by pedal ergometry. Three had p ressure changes with pedal ergometry, but not with treadmill testing and tw o had pressure changes on the treadmill not reproduced by pedal ergometry. Conclusions Pedal ergometer is more sensitive than treadmill testing in det ecting arterial insufficiency, as indicated by a 20% or greater fall in ank le pressure, and more suitable in a subgroup of patients unable to tolerate conventional treadmill testing.