Abstract
Background: Balance deficits are increasingly recognized as an important secondary impairment in COPD, however little is known regarding the specific components of balance that are impaired.
Objectives: 1) To determine the specific components of postural control that are impaired in individuals with COPD compared to age-matched healthy controls; 2) To determine if deficits in balance in COPD are related to muscle strength or physical activity.
Methods: Balance, physical activity and lower extremity muscle strength were assessed in 37 patients with COPD and 20 healthy controls using the Balance Evaluation Systems Test (BESTest), the Physical Activity Scale for the Elderly (PASE), and an isokinetic dynamometer, respectively. A subset of subjects (20 COPD and 20 controls) underwent a second testing session in which postural perturbations were delivered using a lean-and-release system. Center of pressure data were collected from three force plates mounted in the platform.
Results: Subjects with COPD (age 71±7 yrs; FEV1 39±16 percent predicted) exhibited significantly lower scores than controls (age 67±9 yrs) on all of the BESTest subscales (all p<0.0001). The largest detriments in postural control were evident in biomechanics, transitions and gait. The PASE was a significant predictor of BESTest score (p=0.034) in COPD. In response to anterior perturbations, subjects with COPD showed a longer time to foot-off (p=0.027) and foot-on (p=0.018) as well as a longer duration anticipatory phase (p=0.008) compared to controls.
Conclusions: Comprehensive balance assessment and management should be included in pulmonary rehabilitation. Deficits in balance in COPD appear to be related to decreased physical activity levels.
- © 2011 ERS
