Ahmad Irfan, Mathiyakom Witaya, Tantisuwat Anong
Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
Department of Physical Therapy, California State University, Northridge, CA.
Medicine (Baltimore). 2025 Aug 8;104(32):e43609. doi: 10.1097/MD.0000000000043609.
Up to 50% of patients with chronic obstructive pulmonary disease (PwCOPD) experience breathing pattern disorders (BPD) and are at fall risk. Limited information on clinical tests to identify balance and gait impairment and the fall risk in PwCOPD and confirmed BPD (PwCOPD + BPD) is available. This study compared clinical balance and gait measures and fall risk between the PwCOPD + BPD and the older adults without COPD (OAwoCOPD) and correlated the BPD severity to the balance and gait measures. A case-control study was used to describe and compare clinical gait and balance measures between PwCOPD + BPD and OAwoCOPD. Fifty-three PwCOPD + BPD and 53 OAwoCOPD performed 3 trials of the timed up-and-go test, multi-directional reach test, and Fullerton advanced balance scale. The average data of each test was used to compare the 2 groups. The association between the presence of COPD and BPD and the fall risk was tested. The correlation between the severity of BPD and the score of each test was identified. The PwCOPD + BPD performed significantly poorer (P < .05) on all 3 tests than the OAwoCOPD. The proportion of PwCOPD + BPD at fall risk was significantly greater (P < .05) than that of the OAwoCOPD. The PwCOPD + BPD had significantly greater odds ratios (2.227-3.548) of having fall risk than the OAwoCOPD. Significant correlations between the severity of BPD and all measures were noted (P < .05). The PwCOPD + BPD demonstrated impaired balance, gait, and multiple control strategies, leading to a higher fall risk than the OAwoCOPD. The severity of BPD negatively impacts balance and gait measures. These findings highlight the need for balance, gait, and fall screening and prevention in PwCOPD + BPD.
高达50%的慢性阻塞性肺疾病患者(PwCOPD)存在呼吸模式障碍(BPD)且有跌倒风险。目前关于识别PwCOPD和确诊BPD患者(PwCOPD + BPD)平衡和步态障碍以及跌倒风险的临床测试信息有限。本研究比较了PwCOPD + BPD患者与无慢性阻塞性肺疾病的老年人(OAwoCOPD)之间的临床平衡和步态指标以及跌倒风险,并将BPD严重程度与平衡和步态指标进行关联分析。采用病例对照研究来描述和比较PwCOPD + BPD患者与OAwoCOPD患者之间的临床步态和平衡指标。53例PwCOPD + BPD患者和53例OAwoCOPD患者进行了3次计时起立行走测试、多方向伸展测试和富勒顿高级平衡量表测试。使用每项测试的平均数据来比较两组。测试了慢性阻塞性肺疾病和BPD的存在与跌倒风险之间的关联。确定了BPD严重程度与每项测试得分之间的相关性。PwCOPD + BPD患者在所有3项测试中的表现均显著差于(P <.05)OAwoCOPD患者。PwCOPD + BPD患者中存在跌倒风险的比例显著高于(P <.05)OAwoCOPD患者。PwCOPD + BPD患者发生跌倒风险的优势比显著高于(2.227 - 3.548)OAwoCOPD患者。注意到BPD严重程度与所有指标之间存在显著相关性(P <.05)。PwCOPD + BPD患者表现出平衡、步态和多种控制策略受损,导致跌倒风险高于OAwoCOPD患者。BPD的严重程度对平衡和步态指标产生负面影响。这些发现凸显了对PwCOPD + BPD患者进行平衡、步态和跌倒筛查及预防的必要性。