New evaluation of trunk movement and balance during walking in COPD patients by a triaxial accelerometer

Abstract

BackgroundIndividuals with COPD may experience ambulatory difficulty due to both effort intolerance arising from respiratory dysfunction and impaired balance control during walking. However, the trunk movement during walking has not been evaluated or adjusted for patients with COPD. The Lissajous index (LI) visually and numerically evaluates the left–right symmetry of the trunk movement during walking and is useful in clinical practice. In COPD patients, the LI is used as an indicator of the left–right symmetry of the trunk during walking. Here, we used the LI to evaluate the symmetry of COPD patients based on bilateral differences in mediolateral and vertical accelerations, and we investigated the correlation between the patients’ symmetry evaluation results and their physical function.Patients and methodsSixteen stable COPD patients (all males; age 71.3±9.2 years) and 26 healthy control subjects (15 males; age 68.2±6.9 years) participated in this study. They performed the 10-minute walk test at a comfortable gait speed wearing a triaxial accelerometer, and we measured their trunk acceleration for the evaluation of symmetry. Motor functions were also evaluated in the patients with COPD.ResultsThe average mediolateral bilateral difference and LI values of the COPD patients were significantly larger than those of the healthy subjects. The COPD patients’ LI values were significantly correlated with their static balance.ConclusionThe LI measured using a triaxial accelerometer during walking is useful in balance assessments of patients with COPD.

Impairment and characteristics of postural control sub-components in people with COPD: a scoping review

“…In the included studies, “static stability” was assessed for several conditions of visual status (eyes open / eyes closed), stance (natural stance, tandem stance, one leg stance) or surface (stable / unstable surface, foam). A significant alteration of the component was found in the majority of studies: on thirty-five studies comparing COPD and healthy subjects, thirty studies reported a significant decrease in COPD group (twenty-six studies assessing “static stability” in isolation [26–51], four studies with composite tests [52–55]), four studies found no significant differences between groups [56–59] and data were not available in one study [60].…”

“…Some studies using laboratory gait analysis identified impairments in parameters related to “dynamic stability” in COPD patients: alteration of margins of stability (in medio-lateral direction) and its variability [75] and increase of centre of mass medio-lateral sway [60] and acceleration variability [76].…”

“…A significant alteration of the component was found in the majority of studies: on thirty-five studies comparing COPD and healthy subjects, thirty studies reported a significant decrease in COPD group (twenty-six studies assessing "static stability" in isolation , four studies with composite tests [52][53][54][55]), four studies found no significant differences between groups [56][57][58][59] and data were not available in one study [60].…”

Impairment and characteristics of postural control sub-components in people with COPD: a scoping review

“…A significant alteration of the component was found in the majority of studies: on thirty-five studies comparing COPD and healthy subjects, thirty studies reported a significant decrease in COPD group (twenty-six studies assessing "static stability" in isolation , four studies with composite tests [52][53][54][55]), four studies found no significant differences between groups [56][57][58][59] and data were not available in one study [60].…”

“…These three studies were consistent to identify dynamic stability sub-component as one of the most impaired among all postural control sub-component. Some studies using laboratory gait analysis identified impairments in parameters related to "dynamic stability" in COPD patients: alteration of margins of stability (in medio-lateral direction) and its variability [75] and increase of centre of mass medio-lateral sway [60] and acceleration variability [76].…”