Author(s): CUCATO, G.G.1, LONGANO, P.2, CORREIA, M.A.2, RITTI-DIAS, R.M.2, KANEGUSUKU, H.2, Institution: NORTHUMBRIA UNIVERSITY, Country: UNITED KINGDOM, Abstract-ID: 890

INTRODUCTION:
Peripheral artery disease (PAD) is characterized by exercise-induced leg pain and marked reductions in walking capacity, leading to physical inactivity and impaired quality of life. Patients with PAD frequently present both low cardiorespiratory fitness and reduced lower-limb muscle strength, driven by vascular, metabolic, and muscular dysfunctions. Although each impairment has been independently associated with worse quality of life, PAD is a multifactorial condition in which these deficits commonly coexist. Whether the simultaneous presence of low cardiorespiratory fitness and low muscle strength exerts an additive or synergistic negative impact on quality of life in PAD patients remains unclear.
METHODS:
In this cross-sectional study, 205 patients with PAD ankle–brachial index <0.90, intermittent claudication) were evaluated. Cardiorespiratory fitness was assessed using the six-minute walk test and expressed as a percentage of predicted distance covered. Patients in the lowest tertile (<60% predicted) were classified as having low cardiorespiratory fitness. Muscle strength was assessed using the sit-to-stand test, with performance classified into quartiles; patients in the second to fourth quartiles were classified as having low strength. Based on these classifications, patients were allocated into three groups: no impaired fitness component (NC), one impaired component (1C), or both components impaired (2C). Quality of life was assessed using the WHOQOL-Bref questionnaire. Group differences were analyzed using Kruskal–Wallis tests. Associations between joint fitness profiles and quality of life outcomes were examined using multiple linear regression, with results expressed as standardized regression coefficients (β), adjusted for sex, age, and ankle–brachial index. Statistical significance was set at p<0.05.
RESULTS:
Patients with both impairment (2C) reported significantly poorer physical health and social relationship scores than the NC and 1C groups (p < 0.05). After adjustment, worse joint fitness profiles remained independently associated with lower physical health (β = −4.42; p=0.007), social relationships (β = −4.07; p=0.026), and satisfaction with health (β = −4.60; p=0.010). No significant associations were observed for psychological or environmental domains.
CONCLUSION:
Patients with PAD presenting simultaneous impairments in cardiorespiratory fitness and lower-limb muscle strength report worse quality of life, particularly in physical health and social relationship domains. These findings suggest that the coexistence of multiple fitness impairments is associated with greater pain, mobility limitations, and difficulties in daily activities, thereby amplifying the negative impact of PAD on perceived quality of life and highlighting the importance of exercise interventions that target both aerobic capacity and muscle strength.