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. 2014 Mar;47(3):319-25.
doi: 10.1016/j.ejvs.2013.11.010. Epub 2013 Dec 3.

External validation of the "walking estimated limitation calculated by history" (WELCH) questionnaire in patients with claudication

P Abraham  1 , R Godet  2 , M Harbonnier  2 , D Laneelle  3 , G Leftheriotis  4 , N Ouedraogo  4
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Free article

External validation of the "walking estimated limitation calculated by history" (WELCH) questionnaire in patients with claudication

P Abraham et al. Eur J Vasc Endovasc Surg. 2014 Mar.
Free article

Abstract

Objective: To externally validate the recently proposed "Walking Estimated Limitation Calculated by History" (WELCH) questionnaire.

Methods: A prospective study was performed on 450 new patients referred to our laboratory for treadmill testing (constant load 3.2 km/h and 10% slope for 15 minutes and then incremental increases). Results are presented as mean ± SD or median [25th-75th percentiles] or number (percentage). An ankle brachial index <0.90 defined the presence of peripheral artery disease (PAD). Typical "vascular-type claudication" is a lower-limb pain or discomfort that is absent at rest, appears at exercise, forces stopping, and disappears within 10 minutes of exercise stopping. The Spearman r coefficient of correlation between maximal walking time (MWT) on treadmill and WELCH scores was calculated for patients with (PAD+) or without (PAD-) PAD, and reporting typical vascular-type claudication (VTC+) or not (VTC-).

Results: The WELCH score was obtained in all included patients. The number (%) of patients with a WELCH score <25 was 37 (54%), 198 (65%), 14 (44%), and 18 (38%), and the Spearman correlation coefficient between WELCH score and treadmill MWT was 0.588, 0.609, 0.581, and 0.591 in the VTC-/PAD+, VTC+/PAD+, VTC-/PAD-, and VTC+/PAD- groups respectively (all p < .001). In PAD+/VTC+ patients, the WELCH positive predictive value for the inability to walk for 5 minutes on the treadmill was 79%.

Conclusion: The WELCH score correlates moderately with treadmill-walking capacity in patients with or without PAD, and with or without typical VTC. It appears to be a simple to complete and easily scored instrument to help clinicians standardise the subjective estimation of walking capacity in their patients.

Trial registration: ClinicalTrials.gov NCT01114178.

Keywords: Claudication; Exercise; Exercise testing; Peripheral arterial disease; Questionnaires; Walking impairment.

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