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

Liu, Wai-Yan; Schmid, Kendra K.; Meijer, Kenneth; Spruit, Martijn A.; Yentes, Jennifer M.

doi:10.4187/respcare.06743

Cited by 9 publications

(9 citation statements)

References 45 publications

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“…When walking, PwCOPD demonstrated less control, or less consistent, hip and knee joint movement patterns, especially at faster speeds. 81 Step time and step width variability was altered in PwCOPD, 71 as well as step length. 13 Stride frequency variability, as measured by the coefficient of variation, was increased in PwCOPD as compared to controls at speeds faster and slower than their self-selected walking speed; however, these group differences were not found when speed was controlled.…”

Section: Gaitmentioning

confidence: 99%

Updated Perspectives on the Role of Biomechanics in COPD: Considerations for the Clinician

Yentes¹,

Liu²,

Markvicka³

et al. 2022

COPD

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Patients with chronic obstructive pulmonary disease (COPD) demonstrate extra-pulmonary functional decline such as an increased prevalence of falls. Biomechanics offers insight into functional decline by examining mechanics of abnormal movement patterns. This review discusses biomechanics of functional outcomes, muscle mechanics, and breathing mechanics in patients with COPD as well as future directions and clinical perspectives. Patients with COPD demonstrate changes in their postural sway during quiet standing compared to controls, and these deficits are exacerbated when sensory information (eg, eyes closed) is manipulated. If standing balance is disrupted with a perturbation, patients with COPD are slower to return to baseline and their muscle activity is differential from controls. When walking, patients with COPD appear to adopt a gait pattern that may increase stability (eg, shorter and wider steps, decreased gait speed) in addition to altered gait variability. Biomechanical muscle mechanics (ie, tension, extensibility, elasticity, and irritability) alterations with COPD are not well documented, with relatively few articles investigating these properties. On the other hand, dyssynchronous motion of the abdomen and rib cage while breathing is well documented in patients with COPD. Newer biomechanical technologies have allowed for estimation of regional, compartmental, lung volumes during activity such as exercise, as well as respiratory muscle activation during breathing. Future directions of biomechanical analyses in COPD are trending toward wearable sensors, big data, and cloud computing. Each of these offers unique opportunities as well as challenges. Advanced analytics of sensor data can offer insight into the health of a system by quantifying complexity or fluctuations in patterns of movement, as healthy systems demonstrate flexibility and are thus adaptable to changing conditions. Biomechanics may offer clinical utility in prediction of 30-day readmissions, identifying disease severity, and patient monitoring. Biomechanics is complementary to other assessments, capturing what patients do, as well as their capability.

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Section: Gaitmentioning

confidence: 99%

Updated Perspectives on the Role of Biomechanics in COPD: Considerations for the Clinician

Yentes¹,

Liu²,

Markvicka³

et al. 2022

COPD

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“…These results reflect that variability in gait spatiotemporal variables is not always sufficiently discriminative between healthy and COPD patients. Other dynamic variables, such as sample entropy and local divergence exponent (91), were therefore used to quantify joint movement patterns in this population. The results demonstrated more restricted (decreased variability of fluctuation, increased predictability) and less consistent organization (decreased local dynamic stability) of lower limb joint movement patterns in COPDp during gait.…”

Section: Gait Deficitmentioning

confidence: 99%

“…Moreover, while studies, including this one, focused only on the sagittal plane, hip adductor weakness reported in COPD patients confirms the importance of the incorporation of the frontal plane and the need for a full 3-D biomechanical approach. Although different studies (85,91) investigated the variability spatial-temporal parameters of the gait (i.e. step width, step length, cadence, etc.)…”

Section: H3-copd Patients Suffer From Cognitive Impairment Cognitive ...mentioning

confidence: 99%

Falls Incidence and Associated Risk Factors among People with Chronic Obstructive Pulmonary Disease (COPD)

Davoudi¹,

Shokouhyan²,

Abedi³

et al. 2022

Preprint

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Chronic obstructive pulmonary disease (COPD) is increasingly being recognized as a systemic disease rather than a mere disorder of the lungs. Central (respiratory) and peripheral (limb) muscle weakness are among the main pronounced systemic effects of COPD. While the disease primarily affects the lower limb muscles and contributes to gait impairment, COPD is also associated with an increasing risk of falls in patients (COPDp). Previous studies have reported higher rates of falls among COPDp (1.17 to 1.20 falls/person-year), amounting to four times higher than an age-matched healthy group. Potential fall risk factors include muscle weakness, impaired daily activities, cognitive dysfunction, and gait and balance impairment. Although COPDp often manifest many of these risk factors, there remains a gap in literature regarding falls during walking in this population. This study aimed to 1. analyze the literature to identify the risk factors of falling in COPDp, and 2. investigate the underlying mechanisms by which these risk factors can lead to increased prevalence of falling. The results suggest that in addition to the known risk factors of falling, low back pain and mental fatigue should also be considered as relevant risk factors in the treatment process of these patients. Moreover, respiratory problems, which are common in this population, have demonstrated pronounced effects on energy expenditure, gait, and other types of activities of daily living (ADLs), leading to reduced intensity, disrupted coordination of the trunk-pelvic structure with the lower limbs during gait, and altered motor control performance due to activation of muscles in an inefficient synergic manner. These problems potentially lead to the increased vulnerability of these patients to external disturbances and higher incidence risk of falls and injuries. Cognitive problems, which are typically due to reduced oxygen received by the brain, as well as general inflammation caused by COPD, also play a significant role in gait disruption and balance. Future research is warranted to determine the prevalence of falls in COPDp by examining the response of these patients to Medio-Lateral (ML) and Anterior-Posterior (AP) disturbances during gait in association with traditional and recommended fall risk factors.

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“…Coefficient of variation of step time or stride length) [67,77,82] and kinematics parameters (e.g. Ankle range of motion or power absorption at ankle level) [79,81].…”

Section: Dynamic Stabilitymentioning

confidence: 99%

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

Pichon

Hove

Ménard

et al. 2022

Disability and Rehabilitation

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Purpose: Impairment of postural control is a common extra-respiratory manifestation in people with COPD. However, the precise characteristics of this alteration are not clearly known. The "Systems Framework for Postural Control" which define postural control sub-components, is a relevant tool to explore this field. The main aim of this review was to identify which postural control sub-components are impaired in patients with COPD and to summarize characteristics for each sub-component. A secondary aim was to precise the relation between postural control and activities of daily living.Materials and methods: A scoping review was conducted, according to the JBI methodology. Pubmed, Cochrane Library, Scielo, Google Scholar, Open Grey and HAL were searched from inception to March 2021. The search was performed in English and French. Results: Seventy-seven articles were included. There was evidence of a potential impairment for most of the postural control sub-components. Characteristics of every sub-component alteration were heterogeneous. Even if the relation was poorly studied, reduced postural control seemed to be associate with difficulties in activities of daily living. Conclusion: Patients with COPD could experiment impairment among a wide range of postural control sub-components. Future research must clarify if a common pattern of modification exits for this alteration.

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

Cited by 9 publications

References 45 publications

Updated Perspectives on the Role of Biomechanics in COPD: Considerations for the Clinician

Updated Perspectives on the Role of Biomechanics in COPD: Considerations for the Clinician

Falls Incidence and Associated Risk Factors among People with Chronic Obstructive Pulmonary Disease (COPD)

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

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