được lớn nhất trong các biện pháp của sức chịu đựng đi bộ, chẳng hạn như các kiểm tra 6 phút đi bộ. Như mô tả ở trên, triệu chứng ổn định hoặc cải thiện các bệnh nhân PAD với claudication liên tục có thể là | CHAPTER 13 Lower Extremity PAD be greatest in measures of walking endurance such as the 6-minute walk test. As described above symptom stabilization or improvement in PAD patients with intermittent claudication could be due to progressively greater restriction in physical activity thereby reducing leg symptoms caused by exertion. The nature of leg symptoms reported by patients with PAD is associated with the degree of functional decline. For example patients with exertional leg pain that sometimes begins at rest have increased rates of functional decline compared with other PAD patients. Marked functional decline is observed even in asymptomatic PAD patients compared with persons without PAD. Other patient characteristics associated with increased rates of functional decline in PAD include a body mass index greater than 30 kg m2 lack of walking exercise history of pulmonary disease and a history of spinal stenosis. Rates of functional decline among persons with PAD are similar between men and women and between blacks and whites. Although diabetes mellitus and cigarette smoking are associated with an increased risk of critical limb ischemia these characteristics are not associated with increased rates of functional decline among persons with PAD. Stabilization or improvement in leg symptoms over time in patients with intermittent claudication appears to be due to progressive restriction in physical activity Patients with PAD have decreases in objectively measured lower extremity functioning at 2-year follow-up compared with persons without PAD Functional decline in patients with PAD appears to be greatest in measures of walking endurance Among patients with PAD a body mass index greater than 30 kg m2 history of pulmonary disease and history of spinal stenosis are associated with increased rates of functional decline Lack of walking exercise is associated with increased functional decline in patients with PAD Functional decline occurs even in PAD patients who are .