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Gait characteristics and their associations with clinical outcomes in patients with chronic obstructive pulmonary disease

Published on Oct 1, 2019in Gait & Posture2.414
· DOI :10.1016/j.gaitpost.2019.08.012
Masahiro Iwakura2
Estimated H-index: 2
(RMIT: RMIT University),
Kazuki Okura (RMIT: RMIT University)+ 5 AuthorsMasahiko Wakasa4
Estimated H-index: 4
(RMIT: RMIT University)
Abstract
Abstract Background Abnormalities of spatiotemporal gait parameters are frequently observed in chronic obstructive pulmonary disease (COPD). However, associations of gait parameters with clinical outcomes and their implementation into clinical practice have not been established. Research question To investigate gait abnormalities and their association with clinical outcomes of COPD. Methods This study included 34 male outpatients with COPD and 16 community-dwelling healthy men aged ≥65 years. The subjects underwent a ten-metre walk test wearing an accelerometer. Data on gait speed, step length, cadence, walk ratio, acceleration magnitude, and standard deviation of step time (step time SD) were collected. Forced expiratory volume in 1-second, modified Medical Research Council dyspnoea score, six-minute walk distance (6MWD), quadriceps muscle strength (QMVC), and physical activity (daily steps and time spent in moderate to vigorous physical activity per day) were measured in the COPD group as clinical outcomes of COPD. We tested group differences in gait parameters, associations between gait parameters and COPD clinical outcomes, and predictive capability of gait parameters for reductions in 6MWD, QMVC, and daily steps in COPD. Results All gait parameters except walk ratio deteriorated in COPD. Step time SD and gait speed were significant independent predictors of 6MWD in COPD (B=−0.440, p = 0.001, B = 0.339, p = 0.007, respectively). Step length was a significant independent predictor of QMVC (B=−0.609, p  Significance Significant associations between gait abnormalities measured by an accelerometer and deficits in extra-pulmonary features of COPD were observed. An accelerometer-based gait analysis could be an alternative approach to assessing gait abnormalities and screening of functional decline in COPD.
  • References (33)
  • Citations (1)
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References33
Newest
#1Matteo Zago (Polytechnic University of Milan)H-Index: 7
#2Chiarella Sforza (University of Milan)H-Index: 46
Last. Manuela Galli (Polytechnic University of Milan)H-Index: 29
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Abstract Background Gait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD. Research question Thus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD. Methods In line with PRISMA guidelines, a systematic literatu...
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#1Wai-Yan Liu (Maastricht University Medical Centre)H-Index: 3
#2Martijn A. Spruit (Maastricht University Medical Centre)H-Index: 51
Last. Kenneth Meijer (Maastricht University Medical Centre)H-Index: 31
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#1Paola MorlinoH-Index: 1
#2Bruno BalbiH-Index: 1
Last. Antonio Nardone (UNIPV: University of Pavia)H-Index: 19
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Summary Study objective To assess whether gait abnormalities in COPD depend on mere impairment of respiratory function. Methods In 40 patients with COPD at different GOLD stages and 28 controls, we evaluated: forced expiratory volume in 1 s (FEV1); partial pressure of oxygen; Mini-Mental State Examination (MMSE); dynamic balance through the Mini-BESTest (MBT); Timed Up and Go (TUG) test without and with dual task counting aloud back by three; 6-min walk test (6MWT); body sway during quiet stance...
6 CitationsSource
#1Olivier Beauchet (McGill University)H-Index: 59
#2Gilles Allali (University of Geneva)H-Index: 31
Last. Jorunn L. Helbostad (NTNU: Norwegian University of Science and Technology)H-Index: 24
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Background. Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims 1) to give consensus guidance for clinical and spatiotemporal gait analysis based on the recorded footfalls in older adults aged 65 years and over, and 2) to provide reference value...
29 CitationsSource
#1Jennifer M. Yentes (NU: University of Nebraska–Lincoln)H-Index: 9
#2Stephen I. Rennard (UNMC: University of Nebraska Medical Center)H-Index: 99
Last. Nicholas StergiouH-Index: 42
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Rationale: Compared with control subjects, patients with chronic obstructive pulmonary disease (COPD) have an increased incidence of falls and demonstrate balance deficits and alterations in mediolateral trunk acceleration while walking. Measures of gait variability have been implicated as indicators of fall risk, fear of falling, and future falls.Objectives: To investigate whether alterations in gait variability are found in patients with COPD as compared with healthy control subjects.Methods: ...
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#1Yoong Ping Lim (University of Melbourne)H-Index: 2
#2Yi-Chung Lin (University of Melbourne)H-Index: 17
Last. Marcus G. Pandy (University of Melbourne)H-Index: 58
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Abstract The aim of this study was to quantify the effects of step length and step frequency on lower-limb muscle function in walking. Three-dimensional gait data were used in conjunction with musculoskeletal modeling techniques to evaluate muscle function over a range of walking speeds using prescribed combinations of step length and step frequency. The body was modeled as a 10-segment, 21-degree-of-freedom skeleton actuated by 54 muscle-tendon units. Lower-limb muscle forces were calculated us...
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#1Mitsuru YoneyamaH-Index: 15
#2Hiroshi Mitoma (TMU: Tokyo Medical University)H-Index: 12
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Accelerometry is now a well-established method for monitoring human body movements, and is increasingly being used for gait analysis under nonlaboratory conditions because of its low-cost and unobtrusive nature. In order to encourage its use in the clinical setting such as for assessing functional declines due to aging or disease, an extensive database of healthy gait is needed. This paper presents reference data for 245 normal Japanese adults (126 men and 119 women aged 40–86 years) obtained fr...
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#1Jennifer M. Yentes (UNO: University of Nebraska Omaha)H-Index: 9
#2Kendra K. Schmid (UNMC: University of Nebraska Medical Center)H-Index: 15
Last. Nicholas Stergiou (UNMC: University of Nebraska Medical Center)H-Index: 42
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Background Chronic obstructive pulmonary disease (COPD) is characterized by the frequent association of disease outside the lung. The objective of this study was to determine the presence of biomechanical gait abnormalities in COPD patients compared to healthy controls while well rested and without rest.
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#1Lies Lahousse (EUR: Erasmus University Rotterdam)H-Index: 19
#2Vincentius J.A. Verlinden (EUR: Erasmus University Rotterdam)H-Index: 10
Last. M. Arfan Ikram (EUR: Erasmus University Rotterdam)H-Index: 82
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Gait disturbances in patients with chronic obstructive pulmonary disease (COPD) may lead to disability and falls. As studies assessing gait kinematics in COPD are sparse, we investigated associations of COPD with various gait domains and explored a potential link with falling. Gait was measured within the prospective, population-based Rotterdam Study (age ⩾55 years) using an electronic walkway and summarised into seven gait domains: Rhythm, Variability, Phases, Pace, Tandem, Turning and Base of ...
19 CitationsSource
Chronic obstructive pulmonary disease (COPD) is a disease associated with dyspnea, fatigue, and exercise intolerance. The degree of functional debility and level of exercise capacity greatly influences quality of life and mortality in patients with COPD, and the measures of exercise capacity are to be an integral part of patient assessment but often not feasible in routine daily practice, resulting in likely suboptimal care. There is a need for simple ways to identify functional decline in the c...
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#2Sema SavciH-Index: 13
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Abstract Background Cystic Fibrosis (CF), affecting functional exercise capacity generally measured by gait performance, is a progressive, autosomal recessive and metabolic disorder. Evaluating gait performance is necessary to determine the level of disability in patients. Three-axis accelerometers, which are used during gait, are easy way to assess gait parameters in patients and healthy individuals. Research question Do clinical outcomes in CF have an important role in determining gait paramet...
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#1Jige DongH-Index: 1
#2Zhanjun LiH-Index: 1
Last. Hongzhi XieH-Index: 1
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Abstract Background Increasing studies have shown that application of pulmonary rehabilitation may improve the quality of life of chronic obstructive pulmonary disease (COPD) patients. However, the results of some studies still remained controversial and sample size of them limited to small number of participants. A systematic review and meta-analysis was designed to evaluate the efficacy of pulmonary rehabilitation for improving the quality of life in patients with COPD. Methods We searched the...
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