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International Journal of Vascular Medicine
Volume 2012, Article ID 190641, 10 pages
Research Article

Further Clinical Validation of the Walking Impairment Questionnaire for Classification of Walking Performance in Patients with Peripheral Artery Disease

1Department of Community Health and Epidemiology, Queen's University, Kingston, ON, Canada K7L 3N6
2Division of Vascular Surgery, Department of Surgery, Kingston General Hospital, Kingston, ON, Canada K7L 2V7
3Department of Emergency Medicine, Kingston General Hospital, Kingston, ON, Canada K7L 2V7
4School of Nursing, Queen's University, Kingston, ON, Canada K7L 3N6

Received 13 February 2012; Revised 13 April 2012; Accepted 24 April 2012

Academic Editor: John A. Kern

Copyright © 2012 S. P. Sagar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The purpose of this study was to further validate the Walking Impairment Questionnaire (WIQ) as a self-report tool to aid in the clinical identification of walking ability of patients with peripheral artery disease (PAD). 132 patients with PAD and an ankle brachial index (ABI) ≤0.90 were enrolled; 123 provided complete data for the WIQ and standardized graded treadmill test. The WIQ scores were consistent with reported scores in other studies. The absolute claudication distance (ACD) ranged from 42.3 to 1589.2 meters; the peak walking time (PWT) ranged from 68 to 1800 seconds. Adjusted WIQ scores were positively and moderately associated with the log transformed ACD and PWT ( , ). Based on the area under the curve analysis, an overall WIQ score of 42.5 or less identified low performers (sensitivity 0.90, specificity 0.73); the combined subscale score of distance and stair of 75.5 or more identified high performers (sensitivity 0.41, specificity 0.90). We conclude that WIQ cut-offs appropriately classify walking performance in PAD patients, making this a potentially useful clinical tool. Consideration needs to be given to incorporating a standardized WIQ version into practice guidelines and the use of innovative strategies to facilitate clinical uptake.