Validation of a Treadmill Walking Test to Discriminate Neurogenic Claudication From Vascular Claudication
Validation of a Treadmill Walking Test to Discriminate Neurogenic Claudication From Vascular Claudication
The first aim of this study was to elaborate and validate a treadmill walking test that would
 help discriminate between neurogenic claudication from vascular claudication. The second
 objective of this study is to determine if the treadmill walking test can discriminate spinal
 stenosis from low back pain with radiating pain in lower limb.
To date, an important challenge that clinicians hare facing in the assessment and diagnosis
 of intermittent claudication is that pathologies associated with vascular or neurogenic
 claudication can coexist in the same patient. Differentiation between both origins can be
 difficult due to variable signs and symptoms which can be atypical.

 The first aim of this study was to elaborate and validate a treadmill walking test that would
 help discriminate between neurogenic claudication from vascular claudication. The second
 objective of this study is to determine if the treadmill walking test can discriminate spinal
 stenosis from low back pain with radiating pain in lower limb. 60 participants (20 with
 spinal stenosis, 20 with peripheral artery disease and 20 with non-specific low back pain)
 will be recruited. Participants will be invited to walk on a treadmill at a speed of 1,2 mph
 for a maximum of five minutes for both tasks (straight walking posture and inclined walking
 posture). Each walking task will be followed by a rest time of five minutes in sitting
 position. It is hypothesized that walking time difference for the occurrence of pain and for
 pain relief will be sensitive and specific to pathologies and help to discriminate lumbar
 spinal stenosis.
Inclusion Criteria:

 Lumbar spinal stenosis (LSS) group :

 -  Central stenosis

 -  Pain in at least one leg

 -  Neurological signs in the lower limbs (numbness or tingling)

 -  Weaknesses in the lower limb

 -  Pain relieved by sitting or bending the trunk

 Peripheral artery disease (PAD) group :

 -  Claudication while walking

 -  Ankle-brachial index < 0.9

 -  Pain relieved by rest

 Low back pain (LBP) :

 -  Pain radiating in the lower limb

 -  Weaknesses

 -  Pain relieved by sitting

 Exclusion Criteria:

 -  Foraminal stenosis

 -  Spinal stenosis with predominant back pain

 -  Symptomatic disc herniation

 -  Previous lumbar surgery

 -  Previous vascular surgery

 -  Type 1 diabetes

 -  Knee or hip osteoarthritis

 -  Hip or knee arthroplasty

 -  Inability to provide free and informed consent