Risk Factors Contributing to a Postural Balance Impairment in COPD Patients

Abstract

Falls are the fifth-leading cause of death, globally, and they also come with social and economic burdens. In the individual level, falls can result in increased mortality, increased morbidity rate, reduced functioning such as physical activity, and reduced quality of life. Therefore, it is needed to be considered the falls as a single disease. Due to the clinical and social impact of falls, numerous studies were completed on the risk of falls on the elderly population and the diseased population related to motor dysfunction such as Parkinson's or stroke. However, there are still unmentioned diseases which have a higher risk of falls. Chronic Obstructive Pulmonary Disease (COPD) is a disease that has airflow limitation during breathing. COPD patients experience not only lack of oxygen supplementation but also systemic impairment such as cardiovascular problems, impaired muscle function, and impaired cognitive function. Therefore, we assessed the postural balance function and other related variables which were suggested in previous studies. Comorbidities, lung function, body composition, skeletal muscle strength, exercise capacity, balance function, physical activity status, and cognitive function were measured in the Healthy control group and the COPD group. Lung function showed lower values in the COPD group (FEV1, p<0.001), and comorbidity index was higher in the COPD group (Charlson Comorbidity Index, p<0.0001). Muscle strength was lower in the COPD group (inspiratory muscle strength, p=0.0007; maximal leg extension force, p=0.023) and the cognitive function was lower in the COPD group (p<0.0071). Also, the postural balance function measured by the center of pressure showed higher sway velocity in the COPD group (anterior-posterior direction, p<0.0081). However, no difference was found between the groups in Berg Balance Scale and body composition. In the correlation analysis, the reduced balance in the COPD group was significantly associated with increased weight, years of COPD related symptoms, usage of oxygen, comorbidity index (congestive heart failure and diabetes), fat mass, and reduced cognitive function (p<0.05). The aforementioned factors in the COPD can be considered as risk factors related to the reduced postural balance function.