Abstract
Risk of a fall is increased in individuals with chronic obstructive pulmonary disease (COPD), and is usually evaluated using the Berg Balance Scale (BBS), but this is difficult to perform in everyday clinical practice. We aimed to prospectively predict short-term fall recurrence in COPD patients using a predetermined cut-off value of the Timed Up and Go test (TUG). In stable COPD patients, we collected self-reported records of the number of falls in the previous year, and measured TUG and BBS scores for each individual. Records of fall recurrence were obtained prospectively at 6-months after the initial evaluation. Among the 50 patients recruited, 23 (46%) had at least one fall during the past year. The optimal diagnosis value for the TUG to detect a fall was 10.9 s with a sensitivity of 100% and a specificity of 97%. A cut-off of 11 s predicted fall recurrence with high sensitivity and specificity (93% and 74%, respectively). The TUG as well as the BBS score detected fallers, and a cut-off value of 11 s predicted fall recurrence. TUG could be easily incorporated into the scheduled functional evaluations of COPD patients, could predict the risk of a fall and when appropriate, could guide specific balance training exercises to prevent fall.
Highlights
Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality worldwide, impacting daily activities and quality of life
In more-severe COPD patients, falls affected up to 50% of patients entering a pulmonary rehabilitation (PR) program [4], and this value was even higher in patients treated with long-term oxygen therapy (LTOT)
Twenty-three (46%) patients fell in the previous year, with a significantly higher number in the LTOT+ than in the LTOT− group (17 (68%) vs 6 (24%), respectively, p < 0.005)
Summary
Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality worldwide, impacting daily activities and quality of life. A frequent comorbidity in individuals with COPD [1], is recognized as one of the risk factors for falls in the elderly. Fall risk has recently emerged as a concern in COPD. Roig et al [2] found an annual rate of 1.2 falls per COPD patient. In more-severe COPD patients, falls affected up to 50% of patients entering a pulmonary rehabilitation (PR) program [4], and this value was even higher in patients treated with long-term oxygen therapy (LTOT). A history of falls in the previous 6 months is associated with a three-fold increased risk of mortality [5]
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