Abstract
Background and objective: Six-minute walk test (6-MWT) is a widely used test for assessing exercise performance in chronic obstructive pulmonary (COPD). However, the association between reduced walking distance and balance impairment in COPD has not been directly investigated. Therefore, the aim of this study was to identify exercise performance as a predictor for balance impairment in COPD. Materials and Methods: The cross-sectional study was conducted at a single visit involving stable COPD patients in Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand from November 2015 to October 2017. The 6-MWT was measured for in all subjects. The prognostic confounding factors were also collected for all subjects. Balance test was measured using the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test. A cut-off score of BBS < 46 and/or the TUG ≥ 13.5 s was classified as balance impairment. Multivariable logistic regressions were performed to identify the six-minute walk distance (6-MWD) as a predictor for balance impairment in COPD. Results: Of the 176 COPD subjects assessed for eligibility, 118 COPD patients were enrolled including 86 males (72.9%) with a mean age of 73.5 ± 8.1 years. Thirty-three (28.0%) cases were classified with a balance impairment. The 6-MWD < 300 m was the predictor of balance impairment in COPD with an adjusted risk ratio of 10.10 (95%CI; 2.87, 35.61, p-value < 0.001). Conclusions: The 6-MWT is not only useful for evaluation of exercise performance, but also for prediction of balance impairment in patients with COPD. Our study suggests that the 6-MWD < 300 m is an important risk factor for balance impairment in COPD.
Highlights
Chronic obstructive pulmonary disease (COPD) is a respiratory disease that results in progressive airflow limitation and respiratory distress and is one of the most important causes of death worldwide [1]
Thirty-three (28.0%) cases were classified with balance impairment and six (5.1%) cases had a history of falling in the previous year
There were no significant differences between the BMI, ratio of FE1 /forced vital capacity (FVC), % predicted of FEV1, history of falling in the previous year, anxiety, depression, GOLD stage, and inhaled medications of subjects with the balance impairment and non-balance impairment groups
Summary
Chronic obstructive pulmonary disease (COPD) is a respiratory disease that results in progressive airflow limitation and respiratory distress and is one of the most important causes of death worldwide [1]. Reducing the risk of falling by an improved understanding of COPD-related balance impairment is necessary [14]. Impaired balance is an important intrinsic risk factor for falling in COPD patients [6,12,13,15,16]. There are many risk factors for falling including advanced age, muscle weakness, poor physical activity, poor nutritional status, depression, cognitive impairment, visual deficit, cardiovascular comorbidity, female gender, and history of falling in the previous year [6,13,14]. Six-minute walk test (6-MWT) is a widely used test for assessing exercise performance in chronic obstructive pulmonary (COPD). The aim of this study was to identify exercise performance as a predictor for balance impairment in COPD.
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