Impairments in balance discriminate fallers from non-fallers in COPD

BACKGROUND: Preliminary evidence suggests individuals with COPD exhibit deficits in balance. Further investigation of balance and risk of falls is warranted in these patients. The objective of this study was to determine the clinical measures that discriminate fallers from non-fallers among patients with COPD. METHODS: A cross-sectional study design was used. Subjects>60 years with COPD attended a single assessment session. A one-year incidence of falls was collected via self-report questionnaire. Risk of falls and balance were determined using the Berg Balance Scale (BBS), Timed Up and Go Test (TUG) and the Activity-Specific Balance Confidence (ABC) Scale. Exercise tolerance was determined from the Six-Minute Walk Test and functional limitation attributable to dyspnea from the Medical Research Council (MRC) dyspnea scale. RESULTS: Of the 39 COPD subjects (FEV(1)=41.5+/-17.0% predicted; age: 71.1+/-6.8 years) who completed the study, 46% (n=18) reported at least one fall in the preceding year. Significant differences between fallers and non-fallers were found for the ABC (65.8+/-18.2 vs. 81.7+/-11.1; p=0.002), TUG (17.0+/-4.9 vs. 14.0+/-3.1s; p=0.024), BBS (45.2+/-5.4 vs. 48.8+/-5.0; p=0.042), use of supplemental oxygen (72% vs. 24%; p=0.002), and MRC dyspnea scale (median 4, range 3 vs. median 3, range 4; p=0.046). CONCLUSIONS: Patients with COPD fall frequently. Standard clinical balance measures discriminate self-reported fallers from non-fallers. These observations draw attention to an important secondary impairment in COPD.