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慢性阻塞性肺疾病患者的静态和功能平衡:与健康对照的比较以及按性别和疾病严重程度的差异

Static and Functional Balance in Individuals With COPD: Comparison With Healthy Controls and Differences According to Sex and Disease Severity.

作者信息

de Castro Larissa A, Ribeiro Laís Rg, Mesquita Rafael, de Carvalho Débora R, Felcar Josiane M, Merli Myriam F, Fernandes Karen Bp, da Silva Rubens A, Teixeira Denilson C, Spruit Martijn A, Pitta Fabio, Probst Vanessa S

机构信息

Research Centre in Health Sciences (CPCS), University of Northern Parana (UNOPAR), Londrina, Brazil.

Laboratory of Research in Respiratory Physiotherapy (LFIP), Physiotherapy Department, Londrina State University (UEL), Londrina, Brazil.

出版信息

Respir Care. 2016 Nov;61(11):1488-1496. doi: 10.4187/respcare.04749. Epub 2016 Aug 2.

Abstract

BACKGROUND

Studies have shown that individuals with COPD have impaired body balance, probably caused by the disease's multisystemic manifestations plus age-related decline in balance, potentially increasing the risk of falling and its consequences. However, little is known about the profile of individuals with COPD who present balance impairments, especially related to sex and disease severity stages. The aim of this work was to compare static and functional balance between subjects with COPD and healthy controls and to check possible differences according to sex and degrees of disease severity.

METHODS

Forty-seven subjects with COPD and 25 healthy controls were included in this study. Their static balance was assessed in one-legged stance using a force platform and functional balance with the Timed Up and Go test. Additionally, participants performed spirometry, the 6-min walk test and isometric quadriceps maximal voluntary contraction assessment. Disease severity was classified according to the Global Initiative for Obstructive Lung Disease stages and BODE (body mass index, air-flow obstruction, dyspnea, and exercise capacity) scores.

RESULTS

In comparison with healthy controls, subjects with COPD had worse static (center of pressure displacement area: 9.3 ± 1.9 cm vs 11.6 ± 4.0 cm, respectively, P = .01) and functional balance (Timed Up and Go test: 8.5 ± 1.3 s vs 10.3 ± 1.8 s, respectively, P < .001). In the COPD group, men performed better in the Timed Up and Go test than women (9.8 ± 1.2 s vs 10.9 ± 2.2 s, respectively, P = .03), whereas women presented a better static balance in comparison with men for all parameters related to center of pressure (P < .005 for all). Disease severity did not affect any balance results.

CONCLUSIONS

Individuals with COPD had worse static and functional balance in comparison with healthy controls. Sex can mediate these results, depending on the type of balance evaluation (force platform or functional test). Balance performance was similar among the groups classified according to disease severity.

摘要

背景

研究表明,慢性阻塞性肺疾病(COPD)患者存在身体平衡受损的情况,这可能是由该疾病的多系统表现以及与年龄相关的平衡能力下降所致,进而可能增加跌倒风险及其后果。然而,对于存在平衡障碍的COPD患者的特征,尤其是与性别和疾病严重程度阶段相关的特征,人们了解甚少。这项研究的目的是比较COPD患者与健康对照者的静态和功能平衡,并检查根据性别和疾病严重程度的可能差异。

方法

本研究纳入了47例COPD患者和25名健康对照者。使用测力平台在单腿站立姿势下评估他们的静态平衡,并通过定时起立行走测试评估功能平衡。此外,参与者进行了肺活量测定、6分钟步行测试和等长股四头肌最大自主收缩评估。根据慢性阻塞性肺疾病全球倡议阶段和BODE(体重指数、气流阻塞、呼吸困难和运动能力)评分对疾病严重程度进行分类。

结果

与健康对照者相比,COPD患者的静态平衡(压力中心位移面积:分别为9.3±1.9平方厘米和11.6±4.0平方厘米,P = 0.01)和功能平衡(定时起立行走测试:分别为8.5±1.3秒和10.3±1.8秒,P < 0.001)更差。在COPD组中,男性在定时起立行走测试中的表现优于女性(分别为9.8±1.2秒和10.9±2.2秒,P = 0.03),而在与压力中心相关的所有参数方面,女性的静态平衡优于男性(所有P < 0.005)。疾病严重程度未影响任何平衡结果。

结论

与健康对照者相比,COPD患者的静态和功能平衡更差。性别可以介导这些结果,这取决于平衡评估的类型(测力平台或功能测试)。根据疾病严重程度分类的各组之间的平衡表现相似。

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