Marla K Beauchamp1, Kathryn M Sibley2, Bimal Lakhani3, Julia Romano4, Sunita Mathur5, Roger S Goldstein5, Dina Brooks6. 1. Graduate Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada; Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada. 2. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Toronto Rehabilitation Institute, Toronto, ON, Canada. 3. Graduate Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada; Toronto Rehabilitation Institute, Toronto, ON, Canada. 4. Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada. 5. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada. 6. Graduate Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Toronto Rehabilitation Institute, Toronto, ON, Canada. Electronic address: dina.brooks@utoronto.ca.
Abstract
BACKGROUND: Although balance deficits are increasingly recognized in COPD, little is known regarding the disordered subcomponents underlying the control of balance. We aimed to determine the specific components of balance that are impaired in COPD and to investigate the association among balance, peripheral muscle strength, and physical activity. METHODS: Balance, physical activity, and lower extremity muscle strength were assessed in 37 patients with COPD and 20 age-matched healthy control subjects using the Balance Evaluation Systems Test (BESTest), the Physical Activity Scale for the Elderly, and an isokinetic dynamometer, respectively. A subset of subjects (20 patients with COPD and 20 control subjects) underwent a second testing session in which postural perturbations were delivered using a lean-and-release system. RESULTS: Subjects with COPD (age, 71 ± 7 years; FEV(1), 39% ± 16% predicted) exhibited significantly lower scores than did control subjects (age, 67 ± 9 years) on all of the BESTest subscales (all P < .001). In response to anterior perturbations, subjects with COPD showed a longer time to foot-off (P = .027) and foot contact (P = .018), and a longer duration anticipatory phase (P = .008) compared with control subjects. Muscle strength (P = .008) and self-reported physical activity (P = .033) explained 35% of the variance in balance in subjects with COPD. CONCLUSIONS: Individuals with COPD exhibit impairments in all balance subcomponents and demonstrate slower reaction times in response to perturbations. Deficits in balance are associated with reduced physical activity levels and skeletal muscle weakness.
BACKGROUND: Although balance deficits are increasingly recognized in COPD, little is known regarding the disordered subcomponents underlying the control of balance. We aimed to determine the specific components of balance that are impaired in COPD and to investigate the association among balance, peripheral muscle strength, and physical activity. METHODS: Balance, physical activity, and lower extremity muscle strength were assessed in 37 patients with COPD and 20 age-matched healthy control subjects using the Balance Evaluation Systems Test (BESTest), the Physical Activity Scale for the Elderly, and an isokinetic dynamometer, respectively. A subset of subjects (20 patients with COPD and 20 control subjects) underwent a second testing session in which postural perturbations were delivered using a lean-and-release system. RESULTS: Subjects with COPD (age, 71 ± 7 years; FEV(1), 39% ± 16% predicted) exhibited significantly lower scores than did control subjects (age, 67 ± 9 years) on all of the BESTest subscales (all P < .001). In response to anterior perturbations, subjects with COPD showed a longer time to foot-off (P = .027) and foot contact (P = .018), and a longer duration anticipatory phase (P = .008) compared with control subjects. Muscle strength (P = .008) and self-reported physical activity (P = .033) explained 35% of the variance in balance in subjects with COPD. CONCLUSIONS: Individuals with COPD exhibit impairments in all balance subcomponents and demonstrate slower reaction times in response to perturbations. Deficits in balance are associated with reduced physical activity levels and skeletal muscle weakness.
Authors: Rafael Mesquita; Sarah Wilke; Dionne E Smid; Daisy Ja Janssen; Frits Me Franssen; Vanessa S Probst; Emiel Fm Wouters; Jean Wm Muris; Fabio Pitta; Martijn A Spruit Journal: Chron Respir Dis Date: 2016-07-08 Impact factor: 2.444
Authors: François Maltais; Marc Decramer; Richard Casaburi; Esther Barreiro; Yan Burelle; Richard Debigaré; P N Richard Dekhuijzen; Frits Franssen; Ghislaine Gayan-Ramirez; Joaquim Gea; Harry R Gosker; Rik Gosselink; Maurice Hayot; Sabah N A Hussain; Wim Janssens; Micheal I Polkey; Josep Roca; Didier Saey; Annemie M W J Schols; Martijn A Spruit; Michael Steiner; Tanja Taivassalo; Thierry Troosters; Ioannis Vogiatzis; Peter D Wagner Journal: Am J Respir Crit Care Med Date: 2014-05-01 Impact factor: 21.405