Gait patterns in COPD

NewsBot · Feb 25, 2015

Members do not see these Ads. Sign Up.
Gait patterns in COPD: the Rotterdam Study
Lies Lahousse et al
ERJ February 19, 2015

Gait disturbances in patients with chronic obstructive pulmonary disease (COPD) may lead to disability and falls. As studies assessing gait kinematics in COPD are sparse, we investigated associations of COPD with various gait domains and explored a potential link with falling.

Gait was measured within the prospective, population-based Rotterdam Study (age ⩾55 years) using an electronic walkway and summarised into seven gait domains: Rhythm, Variability, Phases, Pace, Tandem, Turning and Base of Support. Rhythm is a temporal gait aspect that includes cadence and reflects how quickly steps are taken.

Persons with COPD (n=196) exhibited worse Rhythm (−0.21 SD, 95% CI −0.36– −0.06 SD) compared with persons with normal lung function (n=898), independent of age, sex, height, education, smoking or analgesic use, especially when dyspnoea and severe airflow limitation or frequent exacerbations (Global Initiative for Chronic Obstructive Lung Disease group D: −0.83 SD, 95% CI −1.25– −0.41 SD) were present. A lower forced expiratory volume in 1 s was associated with worse Rhythm and Pace, including lower cadence and gait velocity, respectively. Importantly, fallers with COPD had significantly worse Rhythm than nonfallers with COPD.

This study demonstrates that persons with COPD exhibit worse Rhythm, especially fallers with COPD. The degree of Rhythm deterioration was associated with the degree of airflow limitation, symptoms and frequency of exacerbations.
Click to expand...

Admin2 · Feb 25, 2015

Related Thread:
Leg fatigue in heart failure

NewsBot · Apr 8, 2016

Gait mechanics in patients with chronic obstructive pulmonary disease.
Yentes JM, Schmid KK, Blanke D, Romberger DJ, Rennard SI, Stergiou N.
Respir Res. 2015 Feb 28;16:31

BACKGROUND:
Chronic obstructive pulmonary disease (COPD) is characterized by the frequent association of disease outside the lung. The objective of this study was to determine the presence of biomechanical gait abnormalities in COPD patients compared to healthy controls while well rested and without rest.
METHODS:
Patients with COPD (N = 17) and aged-matched, healthy controls (N = 21) walked at their self-selected pace down a 10-meter walkway while biomechanical gait variables were collected. A one-minute rest was given between each of the five collected trials to prevent tiredness (REST condition). Patients with COPD then walked at a self-selected pace on a treadmill until the onset of self-reported breathlessness or leg tiredness. Subjects immediately underwent gait analysis with no rest between each of the five collected trials (NO REST condition). Statistical models with and without covariates age, gender, and smoking history were used.
RESULTS:
After adjusting for covariates, COPD patients demonstrated more ankle power absorption in mid-stance (P = 0.006) than controls during both conditions. Both groups during NO REST demonstrated increased gait speed (P = 0.04), stride length (P = 0.03), and peak hip flexion (P = 0.04) with decreased plantarflexion moment (P = 0.04) and increased knee power absorption (P = 0.04) as compared to REST. A significant interaction revealed that peak ankle dorsiflexion moment was maintained from REST to NO REST for COPD but increased for controls (P < 0.01). Stratifying by disease severity did not alter these findings, except that step width decreased in NO REST as compared to REST (P = 0.01). Standardized effect sizes of significant effects varied from 0.5 to 0.98.
CONCLUSIONS:
Patients with COPD appear to demonstrate biomechanical gait changes at the ankle as compared to healthy controls. This was seen not only in increased peak ankle power absorption during no rest but was also demonstrated by a lack of increase in peak ankle dorsiflexion moment from the REST to the NO REST condition as compared to the healthy controls. Furthermore, a wider step width has been associated with fall risk and this could account for the increased incidence of falls in patients with COPD.
Click to expand...

NewsBot · Jun 9, 2016

Variability of gait speed during six minutes walking test in COPD and cystic fibrosis patients
Gregory Reychler et al
JFAS; Article in Press

Highlights
•6MWT is related to higher heart rate, global walking speed and walking distance in CF than in COPD.
•The proportions of CF patients presenting walking speed decline over the 6 minutes were significantly lower than COPD patients.
•Walking speed and cardio-respiratory parameters evolution during 6MWT differ between COPD and CF patients.
Click to expand...

Background
Recently, gait speed reached an increasing importance in the management of respiratory patients. The aim of this retrospective study was to compare walking speed and physiological adaptations during the 6MWT in COPD and CF patients.

Methods
6MWT performed by COPD and CF patients were retrospectively reviewed. Global and sequential walking speeds were measured on six minutes and every sequence of two minutes respectively. Heart rate, oxygen saturation and dyspnea were analyzed.

Results
78 and 246 tests from CF and COPD patients were reviewed respectively. FEV1 (52.3 vs 56.2% pred) and FVC (72.5 vs 73.8% pred) were similar between both diseases. However, 6MWT in patients with CF were characterized by significantly higher heart rate, global walking speed and walking distance (+68%) while dyspnea evolutions and the proportions of patients presenting walking speed decline over the 6 minutes were significantly lower.

Conclusion
Walking speed and cardio-respiratory parameters evolution during 6MWT differ between COPD and CF patients.
Click to expand...

NewsBot · Aug 18, 2017

Gait abnormalities of COPD are not directly related to respiratory function
Paola Morlino et al
Gait and Posture; Article in Press

Highlights
•Balance and gait are affected in COPD.
•Abnormalities of balance and gait are not related to lung impairment.
•Gait abnormalities in COPD might depend on CNS lesion.
Click to expand...

Study objective
To assess whether gait abnormalities in COPD depend on mere impairment of respiratory function.

Methods
In 40 patients with COPD at different GOLD stages and 28 controls, we evaluated: forced expiratory volume in 1 s (FEV1); partial pressure of oxygen; Mini-Mental State Examination (MMSE); dynamic balance through the Mini-BESTest (MBT); Timed Up and Go (TUG) test without and with dual task counting aloud back by three; 6-minute walk test (6MWT); body sway during quiet stance (stabilometry); spatial-temporal variables of gait by a 4-m long sensorized walkway (baropodometry). Lower-limb muscle strength, tendon reflexes, and sensation were also clinically evaluated.

Results
Muscle strength of proximal but not distal muscles was slightly reduced in patients, whereas reflexes and sensation were unaffected. FEV1, partial pressure of oxygen, MMSE, MBT, stabilometry, as well as baropodometry, were abnormal and unrelated to muscle weakness. The time taken to perform the TUG test was increased, and to a larger extent with than without dual task. At baropodometry, variability of step length was increased; abnormalities of gait variables were associated with larger body sway but not with FEV1 or hypoxemia. Gait speed at 6MWT was correlated with MBT score and with FEV1 as well as hypoxemia.

Conclusions
6MWT findings give a measure of gait disability linked to endurance-related respiratory failure. Gait at baropodometry is associated with impairment of balance, cognitive status and abnormal dual task performance. We suggest that central nervous lesions, presumably of vascular origin, are detrimental to balance and gait in COPD.
Click to expand...

NewsBot · Feb 13, 2018

Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review
Matteo Zago et al
Gait and Posture; Article in Press

Highlights
•Controversy still exists on the gait impairments associated with COPD.
•This Review evaluates current understanding of gait features in patients with COPD.
•Main abnormalities were reduced step length/cadence and altered gait variability.
•A mechanistic link between gait impairments and falls in COPD is still lacking.
•Directions for further research are homogeneous cohorts and longitudinal studies.
Click to expand...

Background
Gait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD.

Research question
Thus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD.

Methods
In line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool.

Results
Seven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level.

Significance
A convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD.
Click to expand...

davidh · Feb 16, 2018

I read this stuff and I think to myself "is anyone looking at joint mobility and increased weight?". Certainly the Facebook pic promoting this thread shows a fat couple. Sharing with the readership - feel free to comment.

NewsBot · Jun 4, 2018

Gait Characteristics In Persons With COPD Who Have
Obesity
Micah J. Munoz, Ann Marie N. Wilson, Christian P.
Manhard, Stephen Bailey, FACSM, Gytis Balilionis, Srikant
Vallabhajosula. Elon University, Elon, NC.
Presented at ACSM Mtg, 2018

Persons with Chronic Obstructive Pulmonary Disease (COPD) experience a greater fall
risk than healthy individuals of the same age. Obesity has been associated to an even
greater fall risk in persons with COPD. Gait abnormalities such as an increasing step
width has also been associated with severity of COPD. Recent research has shown that
a high intensity intervention decreases step width in persons with COPD. However,
no research has been done to investigate possible difference in gait pattern between
persons with COPD who have obesity and those who have a healthy body mass index
(BMI). PURPOSE: To investigate differences in gait pattern between people with
COPD who have obesity and those who have a healthy BMI. METHODS: 9 persons
with COPD who have a BMI in the Obese category (OBMI) and 5 persons with COPD
who have a BMI in the healthy category (HBMI) participated. Participants completed 5
trials of walking forward at a comfortable pace on pressure-sensor walkway. Velocity,
cadence, step width, stride length, and stance % were measured as average of 5 trials
and compared between groups using a 2-tailed independent samples t-tests or a Mann-
Whitney U test depending on normality. Hedges’ effect size was also calculated.
RESULTS: OBMI group walked with wider steps showing a trend towards statistical
significance (OBMI: 15.7±4.9cm; HBMI: 9.9±2.5cm; p=0.053). No other variables
were significantly different between the groups. Effect sizes ranged from trivial (0.05
for cadence) to large (1.08 for step width). CONCLUSION: A wider step gait in
OBMI may be related to increased fear of falling. Research with greater sample size
must be done to further investigate the how obesity affects gait patterns in persons with
COPD.
Click to expand...

NewsBot · Feb 19, 2019

Peripheral muscle strength is associated with lung function and functional capacity in patients with cystic fibrosis
Paula Maria Eidt Rovedder Gabrielle Costa Borba Mariluce Anderle Josani Flores Bruna Ziegler Sérgio Saldanha Menna Barreto Paulo de Tarso Roth Dalcin
Physio Res Int: 18 February 2019 https://doi.org/10.1002/pri.1771

Cystic fibrosis (CF) is an inherited disease that causes important multisystemic impairments. The present study aimed to evaluate the association of peripheral muscle strength with lung function and functional capacity in adolescents and adults with CF.

Methods
Cross‐sectional study with prospective data of patients enrolled in the Program for Adults with CF at Hospital de Clínicas de Porto Alegre. The testing procedures included peripheral muscle strength testing, pulmonary function tests, and the 6‐minute walk test.

Results
The sample consisted of 41 subjects (27 women) with a mean age of 24.6. Upper extremity muscle strength was associated with forced vital capacity and forced expiratory volume in the first second, and lower extremity muscle strength was associated with the distance covered in the 6‐minute walk test, oxygen saturation, forced expiratory volume in the first second, and forced vital capacity.

Conclusions
Muscle strength was positively associated with lung function variable and functional capacity in patients with CF.
Click to expand...

NewsBot · Apr 22, 2020

Related Thread:
Foot Orthotics for COPD

NewsBot · Feb 19, 2023

Muscle Power in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis
Simone Pancera , Nicola Francesco Lopomo , Riccardo Buraschi , Joel Pollet , Paolo Pedersini , Stefano Giuseppe Lazzarini , Luca Nicola Cesare Bianchi
Int J Sports Med

This study aimed to review the impact of training on muscle power in patients with chronic obstructive pulmonary disease (COPD). Randomized controlled trials evaluating the effects of exercise-based interventions on limbs muscle power and rate of force development in COPD patients were investigated. Five international databases were searched until October 2022. Meta-analyses were performed calculating the mean difference or standardized mean difference. Risk of bias in studies was assessed using Cochrane Risk of Bias tool 2.0. A total of nine studies were included in the analysis. There were concerns about risk of bias in seven out of nine studies. Comparison of exercising and non-exercising groups showed a significant effect of exercise in improving muscle power (P=0.0004) and rate of force development (P<0.001), in five and three trials, respectively. Four studies comparing different trainings showed no significant results on muscle power (P=0.45). Eight to 16 weeks of exercise-based intervention versus no intervention might be beneficial to enhance upper and lower limbs muscle power and rate of force development in people with COPD. In contrast, muscle power did not improve when different training modalities were compared. Future studies performing power training in COPD patients are encouraged.
Click to expand...

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

davidh Podiatry Arena Veteran

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Abnormal Gait Patterns and an Elevated Degree of Pain after Daily Walking

Heel lifts stiffness of sports shoes could influence posture and gait patterns

Kinematic Gait Patterns in Healthy Runners

Gait Patterns in Children With Limb Length Discrepancy

Shoe sole flexion point influences plantar loading patterns during gait

Corns and Gait patterns - can anybody answer my question?

Out Toe Gait Pattern

Share This Page