Risk Factors for Postural and Functional Balance Impairment in Patients with Chronic Obstructive Pulmonary Disease

Park, Jaekwan K.; Deutz, N.E.P.; Cruthirds, Clayton L.; Kirschner, Sarah; Park, Hangue; Madigan, Michael L.; Engelen, M.P.

doi:10.3390/jcm9020609

Cited by 16 publications

(22 citation statements)

References 54 publications

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“…Park et al 31 , showed that severe COPD patients had impaired postural balance compared to control subjects; also they showed presence of oxygen therapy, fat mass, reduced neurocognitive function and the presence of diabetes explained most of the variation in postural balance in severe COPD patients. Additionally, Ozalevli et al 31 reported that lower limbs fatigue also play an important role in COPD's postural balance. They showed an association between increased self-reported fatigue and balance impairment after manual quadriceps femoris muscle strength test and the six minute walking test in COPD patients.…”

Section: Discussionmentioning

confidence: 99%

Balance impairment and lower limbs strength in patients with COPD who fell in the previous year

Pôrto

Castro

Fausto

et al. 2022

Monaldi Arch Chest Dis

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Fall-related causes in patients with COPD might be associated to functional balance impairments and greater disease severity. We aimed to evaluate the reasons for falls in patients with COPD who had presented any fall during the previous year. This is a cross-sectional study. All COPD’s GOLD classifications (mild, moderate, severe, and very severe) patients were recruited. In order to participate, patients ought to be clinically stable and without any exacerbation within 30 days prior to study entry. History of falls was self-reported by patients through an interview. Pre and post bronchodilator (salbutamol 400 μg) spirometry was performed. All patients accomplished postural balance tests such as the Berg Balance Scale, Falls Efficacy Scale-International, Time up and Go, Functional Reach test, Tinetti test and Chalder Scale; furthermore, lower limbs muscle strength (muscle dynamometry) and the COPD Assessment Test (CAT) were assessed. Ninety-six patients with COPD were evaluated and divided into two groups stratified according to any positive history of falls in the previous year. Patients with COPD who had any fall in the previous year presented older age (p=0.01), higher BMI (p=0.04) and worse pulmonary function than those who did not fall. The risk of falls was increased in patients with lower muscle strength in the lower limbs (OR 2.9, CI 95%;1.6 to 3.9), age greater than 65 years (OR 2.7, CI 95%;1.3 to 3.4), BMI greater than 28.8 kg/m2 (OR 3.2, CI 95%;1.1 to 5.6), very severe airway obstruction (OR 3.9, CI 95%;2.2 to 3.9) and fatigue (OR 3.2, CI 95%;1.5 to 5.3). Impaired body balance, reduced lower limb strength, disease severity, presence of fatigue and elevated BMI are important factors for falls in patients with COPD.

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Section: Discussionmentioning

confidence: 99%

Balance impairment and lower limbs strength in patients with COPD who fell in the previous year

Pôrto

Castro

Fausto

et al. 2022

Monaldi Arch Chest Dis

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“…In fact, low viscoelastic tension worsens the balance ability more specifically in those contexts when the risk of falling is high, i.e. during transition tasks such as passing from sitting to standing, starting to walk or when standing while arm raising 12 , 47 , 49 , 62 – 64 .…”

Section: Discussionmentioning

confidence: 99%

Impact of chronic obstructive pulmonary disease on passive viscoelastic components of the musculoarticular system

Valle

Casabona

Fazio

et al. 2021

Sci Rep

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Chronic obstructive pulmonary disease (COPD) produces skeletal muscle atrophy and weakness, leading to impairments of exercise performance. The mechanical work needed for movement execution is also provided by the passive tension developed by musculoarticular connective tissue. To verify whether COPD affects this component, the passive viscoelastic properties of the knee joint were evaluated in 11 patients with COPD and in 11 healthy individuals. The levels of stiffness and viscosity were assessed by means of the pendulum test, consisting in a series of passive leg oscillations. In addition, to explore the contribution of passive tension in the mechanical output of a simple motor task, voluntary leg flexion–extension movements were performed. Patients with COPD showed a statistically significant reduction in stiffness and viscosity compared to controls. Voluntary execution of flexion–extension movements revealed that the electromyographic activity of the Rectus Femoris and Biceps Femoris was lower in patients than in controls, and the low viscoelastic tension in the patients conditioned the performance of active movements. These results provide novel insights on the mechanism responsible for the movement impairments associated with COPD.

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“…All COPD patients were clinically stable with no history of exacerbation of their disease or a respiratory tract infection at least 4 weeks prior to the study. As previously described, the exclusion criteria were the presence of a fever within 3 days prior to the study day, acute illness, a metabolically unstable chronic illness, pre-existing untreated metabolic or renal disease, malignancy, recent surgery, and use of oral corticosteroids 1 month prior to the study because of known effects on amino acid metabolism [ 43 , 44 ]. As part of the screening process, a medical history was conducted which included the number of exacerbations and medication used.…”

Section: Methodsmentioning

confidence: 99%

“…All study procedures were identical in both groups and conducted as previously described [ 44 ]. Briefly, a digital beam scale and stadiometer were used to measure body weight and height.…”

Section: Methodsmentioning

confidence: 99%

“…Markers of physical function included assessment of upper and lower limb skeletal muscle function, gait speed, and the 6-min walk test (6MWT) and were conducted as done previously [ 44 ]. Briefly, leg strength was quantified by using a Kincom isokinetic dynamometry (Isokinetic International, Chattanooga, TN, USA) to measure the peak leg force during one leg reciprocal extensions (at 60°/s) [ 53 , 54 ].…”

Section: Methodsmentioning

confidence: 99%

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Disturbances in branched-chain amino acid profile and poor daily functioning in mildly depressed chronic obstructive pulmonary disease patients

et al. 2021

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Background Depression is one of the most common and untreated comorbidities in chronic obstructive pulmonary disease (COPD), and is associated with poor health outcomes (e.g. increased hospitalization/exacerbation rates). Although metabolic disturbances have been suggested in depressed non-diseased conditions, comprehensive metabolic phenotyping has never been conducted in those with COPD. We examined whether depressed COPD patients have certain clinical/functional features and exhibit a specific amino acid phenotype which may guide the development of targeted (nutritional) therapies. Methods Seventy-eight outpatients with moderate to severe COPD (GOLD II–IV) were stratified based on presence of depression using a validated questionnaire. Lung function, disease history, habitual physical activity and protein intake, body composition, cognitive and physical performance, and quality of life were measured. Comprehensive metabolic flux analysis was conducted by pulse stable amino acid isotope administration. We obtained blood samples to measure postabsorptive kinetics (production and clearance rates) and plasma concentrations of amino acids by LC–MS/MS. Data are expressed as mean [95% CI]. Stats were done by graphpad Prism 9.1.0. ɑ < 0.05. Results The COPD depressed (CD, n = 27) patients on average had mild depression, were obese (BMI: 31.7 [28.4, 34.9] kg/m2), and were characterized by shorter 6-min walk distance (P = 0.055), physical inactivity (P = 0.03), and poor quality of life (P = 0.01) compared to the non-depressed COPD (CN, n = 51) group. Lung function, disease history, body composition, cognitive performance, and daily protein intake were not different between the groups. In the CD group, plasma branched chain amino acid concentration (BCAA) was lower (P = 0.02), whereas leucine (P = 0.01) and phenylalanine (P = 0.003) clearance rates were higher. Reduced values were found for tyrosine plasma concentration (P = 0.005) even after adjustment for the large neutral amino acid concentration (= sum BCAA, tyrosine, phenylalanine and tryptophan) as a marker of dopamine synthesis (P = 0.048). Conclusion Mild depression in COPD is associated with poor daily performance and quality of life, and a set of metabolic changes in depressed COPD that include perturbation of large neutral amino acids, specifically the BCAAs. Trial registration clinicaltrials.gov: NCT01787682, 11 February 2013—Retrospectively registered; NCT02770092, 12 May 2016—Retrospectively registered; NCT02780219, 23 May 2016—Retrospectively registered; NCT03796455, 8 January 2019—Retrospectively registered.

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Risk Factors for Postural and Functional Balance Impairment in Patients with Chronic Obstructive Pulmonary Disease

Cited by 16 publications

References 54 publications

Balance impairment and lower limbs strength in patients with COPD who fell in the previous year

Balance impairment and lower limbs strength in patients with COPD who fell in the previous year

Impact of chronic obstructive pulmonary disease on passive viscoelastic components of the musculoarticular system

Disturbances in branched-chain amino acid profile and poor daily functioning in mildly depressed chronic obstructive pulmonary disease patients

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