Association of mental health with walking capacity in patients with claudication: a cross-sectional study

Objectives: The purpose of this investigation was to verify the association between mental health (MH) indicators with walking capacity in patients with PAD. Methods: Two hundred and forty-six patients with PAD and claudication symptoms participated in this study. Physical function was assessed objectively with the 6-min walk test (6MWT) and subjectively using the Walking Impairment Questionnaire (WIQ). MH was assessed by the World Health Organization Quality of Life-Bref (WHOQOL-Bref) (six questions were selected - 1, 2, 10, 16, 19, and 26). Patients were divided into tertile groups according to their composite z-score for mental health (Low MH, Middle MH, and High MH). Results: The High MH group presented higher scores (p < 0.05) for the WIQ (distance = 26.8 +/- 25.6, speed = 25.4 +/- 17.3, and stairs = 33.6 +/- 27.5), claudication onset distance (161.6 +/- 83.6 m), and total walking distance (352.9 +/- 79.6 m) compared to Low MH (WIQ distance = 14.8 +/- 16.2, 17.7 +/- 13.0, and stairs = 22.7 +/- 20.7). Additionally, the High MH group presented a longer claudication onset distance (115.5 +/- 70.5 m), and total walking distance in 6MWT (306.6 +/- 83.2 m), and higher scores in the total walking distance compared to Middle MH (309.5 +/- 93.6 m) (p < 0.05). Conclusion: In patients with PAD, MH was positively associated with walking capacity. Based on these results, treatments that can improve mental health, through different mechanisms, can also positively influence the ability of these patients to walk.