Spatiotemporal gait characteristics in patients with COPD during the Gait Real-time Analysis Interactive Lab-based 6-minute walk test

Liu, Wai-Yan; Spruit, Martijn A.; Delbressine, Jeannet M; Willems, Paul; Franssen, Frits M.E.; Wouters, Emiel F.M.; Meijer, Kenneth

doi:10.1371/journal.pone.0190099

Cited by 19 publications

(37 citation statements)

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“…Therefore, reduced strength in the lower limb muscles could be associated with gait alterations and the accompanying stride-to-stride fluctuations. [5][6][7][8]16 In addition, in patients with COPD, the lack of ability to adjust their movement patterns with changes in walking speed, may be associated with an increased susceptibility for balance disturbances and falls, which has been reported in this patient population. 22,23 Subjects in this study did not demonstrate a more restricted gait, as reflected by a reduced variability of fluc-tuations, compared to control subjects.…”

Section: Discussionmentioning

confidence: 85%

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Subjects With COPD Walk With Less Consistent Organization of Movement Patterns of the Lower Extremity

Liu

Schmid

Meijer³

et al. 2019

Respir Care

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BACKGROUND: The inherent stride-to-stride fluctuations during walking are altered in the aging population and could provide insight into gait impairments and falls in patients with COPD. Stride-to-stride fluctuations are quantified two ways: variability of the fluctuations (eg, standard deviation), and movement patterns within the fluctuations. Our objective was to investigate strideto-stride fluctuations by evaluating the variability and movement patterns of lower limb joints in subjects with COPD compared to subjects without COPD as control subjects. METHODS: In this cross-sectional study, 22 subjects with COPD (age 63 ؎ 9 y; FEV 1 54 ؎ 19% predicted) and 22 control subjects (age 62 ؎ 9 y; FEV 1 95 ؎ 18% predicted) walked for 3 min on a treadmill while their gait was recorded. The amount of variability (ie, standard deviation and coefficient of variation) and movement patterns (ie, predictability and consistency in organization) were quantified for the range of motion and joint angle of the hip, knee, and ankle, at 3 walking speeds (ie, self-selected, fast, and slow). General linear mixed models were used for analysis. RESULTS: Control subjects had more consistent organization of the hip and knee joint movement patterns compared to subjects with COPD (P ‫؍‬ .02 and P ‫؍‬ .02, respectively). Further, control subjects adapted to speed changes by demonstrating more consistent organization of movement patterns with faster speeds, whereas subjects with COPD did not. At the fast walking speed, subjects with COPD demonstrated less consistent organization of knee and hip joint movement patterns as compared to control subjects without COPD (P ‫؍‬ .03 and P ‫؍‬ .005, respectively). The amount of variability did not differ between groups. CONCLUSIONS: Although subjects with COPD did not demonstrate decreased amount of variability, their hip and knee joint movement patterns were less consistent in organization during walking. Reduced consistency in organization of movement patterns may be a contributing factor to falls and mobility problems experienced by patients with COPD.

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Section: Discussionmentioning

confidence: 85%

“…A few studies have reported reduced variability in step width and increased variability in step time and stride lengths in subjects with COPD. 8,16 Similar gait changes have been related to increased fall risk in older adults. 17,18 However, these spatiotemporal gait variables provide only a snapshot of gait.…”

Section: Introductionmentioning

confidence: 84%

Subjects With COPD Walk With Less Consistent Organization of Movement Patterns of the Lower Extremity

Liu

Schmid

Meijer³

et al. 2019

Respir Care

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“…Recent studies have demonstrated the possible clinical implications of gait assessment in a clinical setting [141][142][143]. Patients with COPD are able to perform the 6MWT using a self-paced treadmill walking combined with a three-dimensional motion capture system with minimal differences compared to the overground 6MWT [141].…”

Section: Gait Assessment and Trainingmentioning

confidence: 99%

An update on pulmonary rehabilitation techniques for patients with chronic obstructive pulmonary disease

Wouters

Posthuma

Koopman

et al. 2020

Expert Review of Respiratory Medicine

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Introduction: Pulmonary rehabilitation (PR) is one of the core components in the management of patients with chronic obstructive pulmonary disease (COPD). In order to achieve the maximal level of independence, autonomy, and functioning of the patient, targeted therapies and interventions based on the identification of physical, emotional and social traits need to be provided by a dedicated, interdisciplinary PR team. Areas covered: The review discusses cardiopulmonary exercise testing in the selection of different modes of training modalities. Neuromuscular electrical stimulation as well as gait assessment and training are discussed as well as add-on therapies as oxygen, noninvasive ventilator support or endoscopic lung volume reduction in selected patients. The potentials of pulsed inhaled nitric oxide in patients with underlying pulmonary hypertension is explored as well as nutritional support. The impact of sleep quality on outcomes of PR is reviewed. Expert opinion: Individualized, comprehensive intervention based on thorough assessment of physical, emotional, and social traits in COPD patients forms a continuous challenge for health-care professionals and PR organizations in order to dynamically implement and adapt these strategies based on dynamic, more optimal understanding of underlying pathophysiological mechanisms.

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“…All subjects participated in this study between July 2017 and October 2017 after providing written informed consent and primary medical check interviewing history of disorders, age and height by authors (S.S. and Y.N.). The inclusion criteria were as follows: >20 but <60 years of age; no history of brain-related disorders, including surgical operation, irradiation, stroke, infection, remarkable atrophy, or demyelinating disease; no history of hypertension, diabetes mellitus, atrial fibrillation, pulmonary disease, leukoaraiosis, no musculoskeletal deficits or the other diseases showing gait abnormalities without neurological deficits [24][25][26][27]. In the first stage, each subject performed a 10-m walk six times with a tri-axial accelerometer (MG-M1110-HW, LSI Medience, Tokyo, Japan) fixed at the L3 level of the subject by a nylon belt (Figure 1).…”

Section: Subjectsmentioning

confidence: 99%

The Coefficient of Variation of Step Time Can Overestimate Gait Abnormality: Test-Retest Reliability of Gait-Related Parameters Obtained with a Tri-Axial Accelerometer in Healthy Subjects

Fujiwara

Sato

Sugawara

et al. 2020

Sensors

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The aim of this study was to investigate whether variation in gait-related parameters among healthy participants could help detect gait abnormalities. In total, 36 participants (21 men, 15 women; mean age, 35.7 ± 9.9 years) performed a 10-m walk six times while wearing a tri-axial accelerometer fixed at the L3 level. A second walk was performed ≥1 month after the first (mean interval, 49.6 ± 7.6 days). From each 10-m data set, the following nine gait-related parameters were automatically calculated: assessment time, number of steps, stride time, cadence, ground force reaction, step time, coefficient of variation (CV) of step time, velocity, and step length. Six repeated measurement values were averaged for each gait parameter. In addition, for each gait parameter, the difference between the first and second assessments was statistically examined, and the intraclass correlation coefficient (ICC) was calculated with the level of significance set at p < 0.05. Only the CV of step time showed a significant difference between the first and second assessments (p = 0.0188). The CV of step time also showed the lowest ICC, at <0.50 (0.425), among all parameters. Test–retest results of gait assessment using a tri-axial accelerometer showed sufficient reproducibility in terms of the clinical evaluation of all parameters except the CV of step time.

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Spatiotemporal gait characteristics in patients with COPD during the Gait Real-time Analysis Interactive Lab-based 6-minute walk test

Cited by 19 publications

References 50 publications

Subjects With COPD Walk With Less Consistent Organization of Movement Patterns of the Lower Extremity

Subjects With COPD Walk With Less Consistent Organization of Movement Patterns of the Lower Extremity

An update on pulmonary rehabilitation techniques for patients with chronic obstructive pulmonary disease

The Coefficient of Variation of Step Time Can Overestimate Gait Abnormality: Test-Retest Reliability of Gait-Related Parameters Obtained with a Tri-Axial Accelerometer in Healthy Subjects

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