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Use of the Physical Performance Test to Assess Preclinical Disability in Subjects With Asymptomatic Carotid Artery Disease

NC Landgraff, PT, PhD, is Associate Professor, Department of Physical Therapy, Youngstown State University, Youngstown, Ohio
SL Whitney, PT, PhD, NCS, ATC, is Associate Professor, Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pa
EN Rubinstein, PhD, is Adjunct Assistant Professor, Department of Health Information Management, University of Pittsburgh
H Yonas, MD, is Chairman, Department of Neurosurgery, University of New Mexico, Albuquerque, NM

(nlandgraff{at}ysu.edu) Address all correspondence to Dr Landgraff at 7121 Ronloy Pl, Boardman, OH 44512 (USA)

Background and Purpose. The purpose of this study was to determine whether subjects with asymptomatic carotid artery stenosis and occlusion demonstrate deficits in physical performance compared with a comparison group. These deficits may indicate that a person is demonstrating preclinical disability. Subjects. Seventy-one subjects with no known disease and 39 subjects with asymptomatic carotid artery stenosis of moderate and severe degrees or with occlusion were included. Methods. Physical performance was assessed with the 9-item and 7-item versions of the Physical Performance Test (PPT). Individual tasks also were timed for the subjects with disease. Results. There were significant differences between the comparison group and the subjects with carotid artery stenosis on the 9-item PPT (P<.00) and on the 7-item PPT (P<.03). Subjects with asymptomatic carotid artery stenosis and occlusion demonstrated less than optimal performance on the PPT (9-item PPT, =27 of 36; 7-item PPT, =21 of 28). Subjects with moderate stenosis were the slowest in performing the task of simulated eating. Discussion and Conclusion. Subjects with asymptomatic carotid artery stenosis and occlusion exhibited changes in function, as indicated by their performance on the PPT relative to that of a comparison group. This finding may be indicative of preclinical disability, indicating that these people are symptomatic. This indication may affect the medical and surgical options that can be considered for their care. [Landgraff NC, Whitney SL, Rubinstein EN, Yonas H. Use of the Physical Performance Test to assess preclinical disability in subjects with asymptomatic carotid artery disease. Phys Ther. 2006;86:541–548.]

Key Words: Activities of daily living • Cerebrovascular disorders • Geriatric assessment • Predictive value of tests