Skip to main content
SpringerLink
Log in

Association between disease-related factors and balance and falls among the elderly with COPD: a cross-sectional study

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and aims: To investigate the relationship between disease-related factors and balance, and a history of falls in chronic obstructive pulmonary disease (COPD). Methods: Thirty-six patients with COPD and twenty healthy individuals were studied. Pulmonary function (pulmonary function test), hypoxemia (analysis of arterial blood gases), history of falls and tripping (number of falls and tripping in the past year), balance (Berg’s Balance Scale-BBS), quadriceps femoris muscle strength (manual muscle test), and exercise capacity (6-minute walking test-6MWT) were assessed. Results: BBS scores were significantly different between groups (p=0.001). BBS scores, frequency of falls and tripping were correlated in COPD patients (p≤0.01). BBS score and frequency of falls were correlated with dyspnea and peripheral oxygen saturation measured after the 6MWT, partial arterial oxygen pressure, and arterial oxygen saturation values in COPD patients (p<0.05). Conclusions: According to our results, hypoxemia, dyspnea and fatigue are disease- related factors, which are related with balance impairment and falls in COPD patients. For this reason, we suggest that assessment of and training to improve balance impairment among the elderly with COPD should be a component of pulmonary rehabilitation programs in clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Tinetti ME. Clinical practice. Preventing falls in elderly persons. N Engl J Med 2003; 348: 42–9.

    Article  PubMed  Google Scholar 

  2. Sturnieks DL, St George R, Lord SR. Balance disorders in the elderly. Neurophysiol Clin 2008; 38: 467–78.

    Article  CAS  PubMed  Google Scholar 

  3. Lawlor DA, Patel R, Ebrahim S. Association between falls in elderly women and chronic diseases and drug use: cross-sectional study. BMJ 2003; 327: 1–6.

    Article  Google Scholar 

  4. Rabe KF, Hurd S, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2007; 176: 532–55.

    Article  PubMed  Google Scholar 

  5. Wall MP. Predictors of functional performance in communitydwelling people with COPD. J Nurs Scholarsh 2007; 39: 222–8.

    Article  PubMed  Google Scholar 

  6. MacIntyre NR. Mechanisms of functional loss in patients with chronic lung disease. Respir Care 2008; 53: 1177–84.

    PubMed  Google Scholar 

  7. Roig M, Eng JJ, Road J, Reid WD. Falls in patients with chronic obstructive pulmonary disease: a call for further research. Respir Med 2009; 103: 1257–69.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Butcher SJ, Meshke JM, Sheppard MS. Reduction in functional balance, coordination, and mobility measures among patients with stable chronic obstructive pulmonary disease. J Cardiopulm Rehabil 2004; 24: 274–80.

    Article  PubMed  Google Scholar 

  9. Eisner MD, Blanc PD, Yelin EH et al. COPD as a systemic disease: impact on physical functional limitations. Am J Med 2008; 121: 789–96.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Chang AT, Seale H, Walsh J, Brauer SG. Static balance is affected following an exercise task in chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev 2008; 28: 142–5.

    Article  PubMed  Google Scholar 

  11. Beauchamp MK, Hill K, Goldstein RS, Janaudis-Ferreira T, Brooks D. Impairments in balance discriminate fallers from nonfallers in COPD. Respir Med 2009; 103: 1885–91.

    Article  CAS  PubMed  Google Scholar 

  12. The GOLD Expert Panel. Global strategy for the diagnosis, management, and prevention of COPD. Available at: http://www.goldcopd.com Accessed August 8, 2008.

    Google Scholar 

  13. American Thoracic Society. Standardization of Spirometry, 1994 Update. Am J Respir Crit Care Med 1995; 152: 1107–36.

    Article  Google Scholar 

  14. Kacmarek RM, Mack CW, Dimas S. Essentials of Respiratory Therapy, 1st ed. Chicago: Year Book Medical Pubs, 1985.

    Google Scholar 

  15. Hauer K, Lamb SE, Jorstad EJ, Todd C, Becker C; PROFANEGroup. Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age Ageing 2006; 35: 5–10.

    Article  PubMed  Google Scholar 

  16. Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992; 83: S7–11.

    PubMed  Google Scholar 

  17. Daniels I, Worthingham C. Muscle Testing, 5th ed. Philadelphia: W.B. Saunders, 1980.

    Google Scholar 

  18. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the sixminute walk test. Am J Respir Crit Care Med 2002; 166: 111–7.

    Article  Google Scholar 

  19. Weiser PC, Mahler DA, Ryan KP. Dyspnea: Symptom assessment and management. Pulmonary rehabilitation, 1st ed. Philadelphia: J.B. Lippincott Company, 1999.

    Google Scholar 

  20. Cooper CB. Airflow obstruction and exercise. Respir Med 2009; 103: 325–34.

    Article  PubMed  Google Scholar 

  21. Ozalevli S, Ozden A, Gocen Z, Cimrin AH. Comparison of sixminute walking tests conducted with and without supplemental oxygen in patients with chronic obstructive pulmonary disease and exercise-induced oxygen desaturation. Ann Saudi Med 2007; 27: 94–100.

    Article  PubMed  Google Scholar 

  22. Perry MC, Carville SF, Smith IC, Rutherford OM, Newham DJ. Strength, power output and symmetry of leg muscles: effect of age and history of falling. Eur J Appl Physiol 2007; 100: 553–61.

    Article  PubMed  Google Scholar 

  23. Janaudis-Ferreira T, Wadell K, Sundelin G, Lindström B. Thigh muscle strength and endurance in patients with COPD compared with healthy controls. Respir Med 2006; 100: 1451–7.

    Article  PubMed  Google Scholar 

  24. Saey D, Côté CH, Mador MJ et al. Assessment of muscle fatigue during exercise in chronic obstructive pulmonary disease. Muscle Nerve 2006; 34: 62–71.

    Article  PubMed  Google Scholar 

  25. Soguel Schenkel N, Burdet L, de Muralt B, Fitting JW. Oxygen saturation during daily activities in chronic obstructive pulmonary disease. Eur Respir J 1996; 9: 2584–9.

    Article  CAS  PubMed  Google Scholar 

  26. Grant I, Heaton RK, McSweeny AJ, Adams KM, Timms RM. Neuropsychologic findings in hypoxemic chronic obstructive pulmonary disease. Arch Intern Med 1982; 142: 1470–6.

    Article  CAS  PubMed  Google Scholar 

  27. Mahler DA. Mechanisms and measurement of dyspnea in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2006; 3: 234–8.

    Article  PubMed  Google Scholar 

  28. Tinetti ME, Williams TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med 1986; 80: 429–34.

    Article  CAS  PubMed  Google Scholar 

  29. Berg K, Wood-Dauphinée S, Williams JI, Gayton D. Measuring balance in the elderly: preliminary development of an instrument. Physiother Can 1989; 41: 304–11.

    Article  Google Scholar 

  30. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142–8.

    CAS  PubMed  Google Scholar 

  31. Bogle Thorbahn LD, Newton RA. Use of the Berg Balance Test to predict falls in elderly persons. Phys Ther 1996; 76: 576–85.

    CAS  PubMed  Google Scholar 

  32. Boulgarides LK, McGinty SM, Willett JA, Barnes CW. Use of clinical and impairment-based test to predict falls by communitydwelling older adults. Phys Ther 2003; 83: 328–39.

    PubMed  Google Scholar 

  33. Ionescu AA, Schoon E. Osteoporosis in chronic obstructive pulmonary disease. Eur Respir J Suppl 2003; 46: 64s–75s.

    Article  CAS  PubMed  Google Scholar 

  34. Steffen TM, Hacker TA, Mollinger L. Age-and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther 2002; 82: 128–37.

    PubMed  Google Scholar 

  35. Skinner KM, Miller DR, Lincoln E, Lee A, Kazis LE. Concordance between respondent self-reports and medical records for chronic conditions: experience from the Veterans Health Study. J Ambul Care Manage 2005; 28: 102–10.

    Article  PubMed  Google Scholar 

  36. Mancini C, Williamson D, Binkin N, Michieletto F, De Giacomi GV; Gruppo di Lavoro Studio Argento. Epidemiology of falls among the elderly. Ig Sanita Pubbl 2005; 61: 117–32.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Physical Therapy, Dokuz Eylul University, Inciralti, Izmir, TR 35340, Turkey

    Sevgi Ozalevli, Duygu Ilgin & Selnur Narin

  2. Department of Chest Diseases, Dokuz Eylul University, Izmir, Turkey

    Atilla Akkoclu

Authors
  1. Sevgi Ozalevli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Duygu Ilgin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Selnur Narin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Atilla Akkoclu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sevgi Ozalevli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ozalevli, S., Ilgin, D., Narin, S. et al. Association between disease-related factors and balance and falls among the elderly with COPD: a cross-sectional study. Aging Clin Exp Res 23, 372–377 (2011). https://doi.org/10.1007/BF03325235

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03325235

Key words

Search

Navigation