Ucgun Hikmet, Kaya Meltem, Ogun Hamza, Denizoglu Kulli Hilal
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Atlas University, Istanbul 34408, Turkey.
Department of Chest Diseases, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey.
Diagnostics (Basel). 2024 Jul 11;14(14):1489. doi: 10.3390/diagnostics14141489.
Many pulmonary and extrapulmonary factors may impair balance in patients with chronic obstructive pulmonary disease (COPD), but the determinants of this impairment are still debated. The primary aim was to compare both balance-related and independent variables that may affect balance with healthy subjects. The secondary aim was to investigate the potential determinants of balance in patients with COPD. This comparative study recruited 23 patients with COPD and 23 age- and comorbidity-matched healthy subjects. Participants were assessed regarding demographic and clinical data, "Postural Stability Test" (PST), "Limits of Stability Test" (LOST), "Clinical Test of Sensory Integration of Balance" (CTSIB), pulmonary function, respiratory and peripheral muscle strength, functional capacity, and cognitive function. There were significant differences in all outcome measures assessing balance, pulmonary function, respiratory muscle strength, peripheral muscle strength, and functional capacity, but not cognitive function, in the COPD group compared to the healthy group ( < 0.05). The PST had a significant and strong correlation with maximal inspiratory pressure (MIP) (r = -0.630, = 0.001) and a significant and moderate correlation with m. quadriceps strength and 6 min walk test (6MWT) distance (r = -0.472, = 0.023; r = -0.496, = 0.016; respectively). MIP, m. quadriceps strength, and 6MWT distance were independent predictors to explain the PST with an R = 0.336 ( = 0.004). The present study revealed that balance is impaired in adults with COPD, even if compared with age- and comorbidity-matched healthy subjects. Assessing and improving balance and its determinants, inspiratory and peripheral muscle strength, and functional capacity may be important for fall prevention and disease management in patients with COPD.
许多肺部和肺外因素可能会损害慢性阻塞性肺疾病（COPD）患者的平衡能力，但这种损害的决定因素仍存在争议。主要目的是比较可能影响平衡的与平衡相关及独立变量与健康受试者。次要目的是研究COPD患者平衡的潜在决定因素。这项比较研究招募了23例COPD患者和23例年龄及合并症匹配的健康受试者。对参与者进行了人口统计学和临床数据、“姿势稳定性测试”（PST）、“稳定性极限测试”（LOST）、“平衡感觉统合临床测试”（CTSIB）、肺功能、呼吸和外周肌肉力量、功能能力以及认知功能的评估。与健康组相比，COPD组在评估平衡、肺功能、呼吸肌力量、外周肌肉力量和功能能力的所有结局指标上均存在显著差异，但在认知功能方面无显著差异（<0.05）。PST与最大吸气压（MIP）具有显著且强烈的相关性（r = -0.630， = 0.001），与股四头肌力量和6分钟步行试验（6MWT）距离具有显著且中等程度的相关性（分别为r = -0.472， = 0.023；r = -0.496， = 0.016）。MIP、股四头肌力量和6MWT距离是解释PST的独立预测因素，R = 0.336（ = 0.004）。本研究表明，即使与年龄及合并症匹配的健康受试者相比，COPD成年患者的平衡能力也会受损。评估和改善平衡及其决定因素、吸气和外周肌肉力量以及功能能力对于COPD患者预防跌倒和疾病管理可能很重要。
