Advertisement

Time and reliability issues associated with automatic vs. manual measurements of Ankle to Brachial pressure Index (ABI) following heavy load exercise

Published:October 29, 2014DOI:https://doi.org/10.1016/j.jsams.2014.10.007

      Abstract

      Objectives

      Ankle to brachial index after heavy load exercise is the most accurate way of diagnosing minor arterial lesions in athletes, such as endofibrosis. The reliability and practical aspects of ankle to brachial index measurements after heavy-load exercise have not been studied. The purpose of this study was to analyze the interest of oscillometric automatic vs. manual Doppler measurements, for the calculation of ankle to brachial index, after heavy-load exercise in athletes.

      Design

      Prospective single-center study.

      Methods

      Fifteen healthy trained athletes performed an incremental test twice. Ankle to brachial index measurements were performed at Rest, as soon as possible after exercise (Rec-0), and then started at the 3rd minute of recovery (Rec-3), by two operators using each one of the two ankle to brachial index measurement methods.

      Results

      Mean times for automatic vs. manual ankle to brachial availability were 99 ± 18 s vs. 113 ± 25 s (p = 0.005) and 44 ± 25 s vs. 53 ± 12 s (p = 0.001) respectively at Rec-0 and Rec-3. Ankle to brachial index values from the two methods were highly correlated (r = 0.89). Mean absolute differences of automatic vs. manual ankle to brachial values from test–retest were 0.04 ± 0.05 vs. 0.08 ± 0.08 (p > 0.05) and 0.07 ± 0.05 vs. 0.09 ± 0.10 (p > 0.05) at Rest and Rec-0.

      Conclusions

      Automatic method allows obtaining faster and simultaneously post-exercise ankle to brachial index measurement compare to the manual Doppler. This time issue does not result in a significant change in absolute ankle to brachial index values, nor in the absolute differences of these in test–retest. Nevertheless, the test–retest variability of post-exercise ankle to brachial index results seems smaller with the automatic than the manual method.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Science and Medicine in Sport
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hirsch A.T.
        • Haskal Z.J.
        • Hertzer N.R.
        • et al.
        ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation.
        Circulation. 2006; 113: e463-e654
        • Selvin E.
        • Erlinger T.P.
        Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999–2000.
        Circulation. 2004; 110: 738-743
        • Feringa H.H.
        • Bax J.J.
        • Van Waning V.H.
        • et al.
        The long-term prognostic value of the resting and postexercise ankle–brachial index.
        Arch Intern Med. 2006; 166: 529-535
        • Feugier P.
        • Chevalier J.M.
        Endofibrosis of the iliac arteries: an underestimated problem.
        Acta Chir Belg. 2004; 104: 635-640
        • Criqui M.H.
        • Fronek A.
        • Barrett-Connor E.
        • et al.
        The prevalence of peripheral arterial disease in a defined population.
        Circulation. 1985; 71: 510-515
        • Bruneau A.
        • Le Faucheur A.
        • Mahe G.
        • et al.
        Endofibrosis in athletes: is a simple bedside exercise helpful or sufficient for the diagnosis?.
        Clin J Sport Med. 2009; 19: 282-286
        • Aboyans V.
        • Criqui M.H.
        • Abraham P.
        • et al.
        Measurement and interpretation of the ankle–brachial index: a scientific statement from the American Heart Association.
        Circulation. 2012; 126: 2890-2909
        • Mundt K.A.
        • Chambless L.E.
        • Burnham C.B.
        • et al.
        Measuring ankle systolic blood pressure: validation of the Dinamap 1846 SX.
        Angiology. 1992; 43: 555-566
        • Korno M.
        • Eldrup N.
        • Sillesen H.
        Comparison of ankle–brachial index measured by an automated oscillometric apparatus with that by standard Doppler technique in vascular patients.
        Eur J Vasc Endovasc Surg. 2009; 38: 610-615
        • MacDougall A.M.
        • Tandon V.
        • Wilson M.P.
        • et al.
        Oscillometric measurement of ankle–brachial index.
        Can J Cardiol. 2008; 24: 49-51
        • Richart T.
        • Kuznetsova T.
        • Wizner B.
        • et al.
        Validation of automated oscillometric versus manual measurement of the ankle–brachial index.
        Hypertens Res. 2009; 32: 884-888
        • Ramanathan A.
        • Conaghan P.J.
        • Jenkinson A.D.
        • et al.
        Comparison of ankle–brachial pressure index measurements using an automated oscillometric device with the standard Doppler ultrasound technique.
        ANZ J Surg. 2003; 73: 105-108
        • Sinski M.
        • Styczynski G.
        • Szmigielski C.
        Automated oscillometric measurement of the ankle–brachial index in patients with coronary artery disease.
        Hypertens Res. 2012; 36: 25-28
        • Beckman J.A.
        • Higgins C.O.
        • Gerhard-Herman M.
        Automated oscillometric determination of the ankle–brachial index provides accuracy necessary for office practice.
        Hypertension. 2006; 47: 35-38
        • Benchimol D.
        • Pillois X.
        • Oysel-Mestre M.
        • et al.
        Ankle brachial index using an automatic blood pressure device in occupational medicine: relevance in routine examination and comparison with Framingham cardio-vascular risk score.
        Int J Clin Pract. 2012; 66: 862-866
        • Kollias A.
        • Xilomenos A.
        • Protogerou A.
        • et al.
        Automated determination of the ankle–brachial index using an oscillometric blood pressure monitor: validation vs. Doppler measurement and cardiovascular risk factor profile.
        Hypertens Res. 2011; 34: 825-830
        • Clairotte C.
        • Retout S.
        • Potier L.
        • et al.
        Automated ankle–brachial pressure index measurement by clinical staff for peripheral arterial disease diagnosis in nondiabetic and diabetic patients.
        Diabetes Care. 2009; 32: 1231-1236
        • Hill D.W.
        • Collins M.A.
        • Cureton K.J.
        • et al.
        Blood pressure response after weight training exercise.
        J Appl Sport Sci Res. 1989; 3: 44-47
        • Pescatello L.S.
        • Guidry M.A.
        • Blanchard B.E.
        • et al.
        Exercise intensity alters postexercise hypotension.
        J Hypertens. 2004; 22: 1881-1888
        • Reinders A.
        • Reggiori F.
        • Shennan A.H.
        Validation of the DINAMAP ProCare blood pressure device according to the international protocol in an adult population.
        Blood Press Monit. 2006; 11: 293-296
        • Abraham P.
        • Bickert S.
        • Vielle B.
        • et al.
        Pressure measurements at rest and after heavy exercise to detect moderate arterial lesions in athletes.
        J Vasc Surg. 2001; 33: 721-727
        • Le Faucheur A.
        • Noury-Desvaux B.
        • Jaquinandi V.
        • et al.
        Simultaneous arterial pressure recordings improve the detection of endofibrosis.
        Med Sci Sports Exerc. 2006; 38: 1889-1894
        • Diehm N.
        • Dick F.
        • Czuprin C.
        • et al.
        Oscillometric measurement of ankle–brachial index in patients with suspected peripheral disease: comparison with Doppler method.
        Swiss Med Wkly. 2009; 139: 357-363
        • Aboyans V.
        • Lacroix P.
        • Doucet S.
        • et al.
        Diagnosis of peripheral arterial disease in general practice: can the ankle–brachial index be measured either by pulse palpation or an automatic blood pressure device?.
        Int J Clin Pract. 2008; 62: 1001-1007
        • Fowkes F.G.
        • Housley E.
        • Cawood E.H.
        • et al.
        Edinburgh Artery Study: prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population.
        Int J Epidemiol. 1991; 20: 384-392
        • Hiatt W.R.
        • Hoag S.
        • Hamman R.F.
        Effect of diagnostic criteria on the prevalence of peripheral arterial disease. The San Luis Valley Diabetes Study.
        Circulation. 1995; 91: 1472-1479
        • Smith F.B.
        • Lee A.J.
        • Price J.F.
        • et al.
        Changes in ankle brachial index in symptomatic and asymptomatic subjects in the general population.
        J Vasc Surg. 2003; 38: 1323-1330