Abstract
Pulmonary rehabilitation (PR) improves lower-limb muscle function in patients with chronic obstructive pulmonary disease (COPD). However, it remains unclear whether patients improve gait characteristics, in particular stride-to-stride fluctuations that are associated with fall risks. This study aims to identify whether, and to what extent, PR affects positively gait characteristics in COPD. In this prospective observational study, 44 COPD patients (aged: 62 ± 7 years; Forced expiratory volume in 1 s 56 ± 20% predicted) performed self-paced, treadmill 6-min-walk tests (Gait Real-time Analysis Interactive Lab) before and after PR, while spatiotemporal parameters and center of mass position were recorded (100 Hz, Vicon Nexus). Standard deviation, coefficient of variation, predictability (sample entropy), and consistency in organization (local divergence exponent) were calculated. Sub-analysis was performed to identify gait differences between good and poor responders (<30 m change in a 6-min-walk distance). Patients demonstrated shorter stride times (p = 0.001) and improved lower-limb muscle function (p < 0.001) following PR. The good responders had a greater increase in stride length (p < 0.001) and a greater decrease in stride time (p < 0.001) compared to the poor responders. Current PR improved stride time in patients, while movement patterns within stride-to-stride fluctuations did not change. Training programs specifically targeting balance issues and gait function may be beneficial in improving gait characteristics in COPD.
Highlights
Walking has been reported as a problematic activity in daily life in patients with chronic obstructive pulmonary disease (COPD) [1,2]
Patients walked 512 ± 67 m during the best overground 6-min-walk test (6MWT), corresponding to 80 ± 10% predicted, and 506 ± 75 m during the best pre-rehabilitation GRAIL-based 6MWT (Table 3)
This study showed that patients with COPD demonstrate shorter stride times during the GRAIL-based 6MWT after a comprehensive Pulmonary rehabilitation (PR) program
Summary
Walking has been reported as a problematic activity in daily life in patients with chronic obstructive pulmonary disease (COPD) [1,2]. Patients with COPD are characterized by gait alterations as compared to healthy older adults [3,4,5,6,7]. These gait alterations, in particular changes in the inherent stride-to-stride fluctuations, have been associated with non-communicable diseases [8,9] and falls in the aging population [10,11,12,13]. Alterations in the amount and patterns of stride-to-stride fluctuations, whether too rigid or too random, are associated with aging, disease and falls [6,9,10,15] in many cases. Improved insight into gait deficits in patients with COPD may direct future training programs focusing on gait function
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
