Chronic obstructive pulmonary disease phenotypes and balance impairment

Int J Chron Obstruct Pulmon Dis. 2016 Apr 29:11:919-25. doi: 10.2147/COPD.S101128. eCollection 2016.

Abstract

Background/objective: Chronic obstructive pulmonary disease (COPD) is a respiratory disease that results in airflow limitation and respiratory distress, also having many nonrespiratory manifestations that affect both function and mobility. Preliminary evidence suggests that balance deficits constitute an important secondary impairment in individuals with COPD. Our objective was to investigate balance performance in two groups of COPD patients with different body compositions and to observe which of these groups are more likely to experience falls in the future.

Methods: We included 27 stable COPD patients and 17 healthy individuals who performed a series of balance tests. The COPD patients were divided in two groups: emphysematous and bronchitic. Patients completed the activities balance confidence scale and the COPD assessment test questionnaire and afterward performed the Berg Balance Scale, timed up and go, single leg stance and 6-minute walking distance test. We analyzed the differences in the balance tests between the studied groups.

Results: Bronchitic COPD was associated with a decreased value when compared to emphysematous COPD for the following variables: single leg stance (8.7 vs 15.6; P<0.001) and activities balance confidence (53.2 vs 74.2; P=0.001). Bronchitic COPD patients had a significantly higher value of timed up and go test compared to patients with emphysematous COPD (14.7 vs 12.8; P=0.001).

Conclusion: Patients with COPD have a higher balance impairment than their healthy peers. Moreover, we observed that the bronchitic COPD phenotype is more likely to experience falls compared to the emphysematous phenotype.

Keywords: body composition; bronchtic; cachexia; emphysematous; falls; muscle wasting; obese.

Publication types

  • Comparative Study

MeSH terms

  • Accidental Falls
  • Adiposity
  • Body Mass Index
  • Bronchitis, Chronic / complications*
  • Bronchitis, Chronic / diagnosis
  • Bronchitis, Chronic / physiopathology
  • Case-Control Studies
  • Forced Expiratory Volume
  • Health Status
  • Humans
  • Lung / physiopathology
  • Muscle Strength
  • Muscle, Skeletal / physiopathology
  • Phenotype
  • Postural Balance*
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Emphysema / complications*
  • Pulmonary Emphysema / diagnosis
  • Pulmonary Emphysema / physiopathology
  • Risk Factors
  • Sensation Disorders / diagnosis
  • Sensation Disorders / etiology*
  • Sensation Disorders / physiopathology
  • Vital Capacity
  • Walk Test