Pichon Romain, Ménard Mathieu, Haering Diane, Crétual Armel, Beaumont Marc
Institut de Formation en Pédicurie-Podologie, Ergothérapie et Kinésithérapie (IFPEK), Rennes, France (Mr Pichon); M2S Laboratory, University Rennes 2, Rennes, France (Mr Pichon and Drs Ménard, Haering, and Crétual); Institut d'Ostéopathie de Rennes-Bretagne (IO-RB), Bruz, France (Dr Ménard); and Pulmonary Rehabilitation Unit, Morlaix, France, and Inserm, Univ Brest, CHRU Brest, UMR 1304, GETBO, Brest, France (Dr Beaumont).
J Cardiopulm Rehabil Prev. 2023 May 1;43(3):198-204. doi: 10.1097/HCR.0000000000000762. Epub 2022 Dec 26.
Postural control impairment has been identified as a potential extrarespiratory manifestation in patients with chronic obstructive pulmonary disease (COPD). The aims of this study were to identify clinical factors that characterize patients with reduced postural control, to examine the correlation between clinical factors and postural control and to determine predictors of an impaired postural control among COPD participants enrolled in a pulmonary rehabilitation (PR) program.
This study is a secondary analysis of an observational study (PARACHUTE). The baseline assessment of the PR program was used for the analysis. Postural control impairment was defined using the Brief BESTest score (BBT).
Participants (n = 73) were included in the analysis, 43 of them were classified in the reduced postural control group. The between-group comparison (non-reduced vs reduced postural control) identified differences for partial pressure in oxygen (Pa O2 ), Saint George Respiratory Questionnaire (SGRQ) total score and subscores (SGRQ-Symptoms, SGRQ-Activities, and SGRQ-Impact), COPD assessment test (CAT), and anxiety score of the Hospital Anxiety and Depression Scale. The BBT score was significantly correlated with maximal inspiratory pressure (MIP), SGRQ, SGRQ-Symptoms, SGRQ-Impact, Falls Efficacy Scale, modified Medical Research Council Scale, 6-min walk test, and Pa O2 . Logistic regression identified SGRQ-Symptoms, Pa O2 , MIP, and body mass index (BMI) as predictors of the presence of reduced postural control.
Low quality of life (QoL) and Pa O2 and high anxiety seem to be discriminative characteristics of patients with COPD with reduced postural control. Furthermore, QoL, Pa O2 , inspiratory muscle strength, and BMI seem to be acceptable predictors of the presence of postural control impairment.
姿势控制受损已被确认为慢性阻塞性肺疾病（COPD）患者潜在的呼吸外表现。本研究的目的是确定表征姿势控制能力下降患者的临床因素，检查临床因素与姿势控制之间的相关性，并确定参加肺康复（PR）计划的COPD参与者中姿势控制受损的预测因素。
本研究是一项观察性研究（PARACHUTE）的二次分析。使用PR计划的基线评估进行分析。姿势控制受损通过简短BESTest评分（BBT）来定义。
73名参与者纳入分析，其中43名被归类为姿势控制能力下降组。组间比较（姿势控制能力未下降组与下降组）发现，氧分压（Pa O2）、圣乔治呼吸问卷（SGRQ）总分及各子分数（SGRQ-症状、SGRQ-活动和SGRQ-影响）、COPD评估测试（CAT）以及医院焦虑抑郁量表的焦虑评分存在差异。BBT评分与最大吸气压（MIP）、SGRQ、SGRQ-症状、SGRQ-影响、跌倒效能量表、改良医学研究委员会量表、6分钟步行试验和Pa O2显著相关。逻辑回归确定SGRQ-症状、Pa O2、MIP和体重指数（BMI）为姿势控制能力下降的预测因素。
生活质量（QoL）低下、Pa O2降低和高度焦虑似乎是姿势控制能力下降的COPD患者的鉴别特征。此外，QoL、Pa O2、吸气肌力量和BMI似乎是姿势控制受损存在的可接受预测因素。
