Balance, gait, and postural control impairment and fall risk in patients with chronic obstructive pulmonary disease and breathing pattern disorder: A case-control study

Up to 50% of patients with chronic obstructive pulmonary disease (PwCOPD) experience breathing pattern disorders (BPD) and are at fall risk. Limited information on clinical tests to identify balance and gait impairment and the fall risk in PwCOPD and confirmed BPD (PwCOPD + BPD) is available. This study compared clinical balance and gait measures and fall risk between the PwCOPD + BPD and the older adults without COPD (OAwoCOPD) and correlated the BPD severity to the balance and gait measures. A case-control study was used to describe and compare clinical gait and balance measures between PwCOPD + BPD and OAwoCOPD. Fifty-three PwCOPD + BPD and 53 OAwoCOPD performed 3 trials of the timed up-and-go test, multi-directional reach test, and Fullerton advanced balance scale. The average data of each test was used to compare the 2 groups. The association between the presence of COPD and BPD and the fall risk was tested. The correlation between the severity of BPD and the score of each test was identified. The PwCOPD + BPD performed significantly poorer (P < .05) on all 3 tests than the OAwoCOPD. The proportion of PwCOPD + BPD at fall risk was significantly greater (P < .05) than that of the OAwoCOPD. The PwCOPD + BPD had significantly greater odds ratios (2.227-3.548) of having fall risk than the OAwoCOPD. Significant correlations between the severity of BPD and all measures were noted (P < .05). The PwCOPD + BPD demonstrated impaired balance, gait, and multiple control strategies, leading to a higher fall risk than the OAwoCOPD. The severity of BPD negatively impacts balance and gait measures. These findings highlight the need for balance, gait, and fall screening and prevention in PwCOPD + BPD.