Gait,ankle mobility,muscle strength,and functional performance in chronic venous insufficiency: A CEAP-based analysis

Abstract

Objectives

Chronic venous disease (CVD) is a progressive condition affecting the lower limb venous system, leading to venous hypertension, muscle dysfunction, and gait alterations. Patients with CVD often experience muscle weakness, reduced ankle mobility, and impaired gait biomechanics. However, the impact of CVD severity on spatiotemporal gait parameters and plantar flexor strength remains little explored. The present study aimed to compare gait biomechanics, plantar flexor strength, dorsiflexion ankle range of motion, and functional performance among patients with mild, moderate, and severe CVD, classified according to the CEAP system.

Methods

A cross-sectional study was conducted in two phases. Phase 1 compared gait parameters between healthy individuals and patients with CVD. Phase 2 examined variations in movement patterns across CVD severity groups, classified according to CEAP class into mild CVD (CEAP 1; n = 11), moderate CVD (CEAP 2–3; n = 12), and severe CVD (CEAP 4–6; n = 6). Gait parameters, including speed, stride length, and stance time, were assessed using a motion capture system. Plantar flexor strength was measured with a handheld dynamometer. Ankle dorsiflexion range of motion was assessed using the Weight-Bearing Lunge Test (WBLT), and functional performance was evaluated using the Human Activity Profile (HAP) questionnaire.

Results

No significant differences were observed in spatiotemporal gait parameters between healthy individuals and patients with CVD or across disease severity groups. In contrast, normalized plantar flexor strength differed significantly among groups (p = .041). Ankle dorsiflexion range of motion was also reduced with increasing disease severity (p = .005), particularly in the severe group. No significant differences were found for HAP scores.

Conclusion

CVD severity was associated with reduced plantar flexor strength and ankle dorsiflexion range of motion, while spatiotemporal gait parameters remained unchanged. These findings suggest that musculoskeletal impairments may precede detectable alterations in gait, highlighting the importance of early assessment and targeted rehabilitation strategies in patients with CVD.