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      New evaluation of trunk movement and balance during walking in COPD patients by a triaxial accelerometer

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          Individuals with COPD may experience ambulatory difficulty due to both effort intolerance arising from respiratory dysfunction and impaired balance control during walking. However, the trunk movement during walking has not been evaluated or adjusted for patients with COPD. The Lissajous index (LI) visually and numerically evaluates the left–right symmetry of the trunk movement during walking and is useful in clinical practice. In COPD patients, the LI is used as an indicator of the left–right symmetry of the trunk during walking. Here, we used the LI to evaluate the symmetry of COPD patients based on bilateral differences in mediolateral and vertical accelerations, and we investigated the correlation between the patients’ symmetry evaluation results and their physical function.

          Patients and methods

          Sixteen stable COPD patients (all males; age 71.3±9.2 years) and 26 healthy control subjects (15 males; age 68.2±6.9 years) participated in this study. They performed the 10-minute walk test at a comfortable gait speed wearing a triaxial accelerometer, and we measured their trunk acceleration for the evaluation of symmetry. Motor functions were also evaluated in the patients with COPD.


          The average mediolateral bilateral difference and LI values of the COPD patients were significantly larger than those of the healthy subjects. The COPD patients’ LI values were significantly correlated with their static balance.


          The LI measured using a triaxial accelerometer during walking is useful in balance assessments of patients with COPD.

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          Most cited references 22

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          Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper.

           W MacNee,  ,  B Celli (2004)
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            Skeletal muscle dysfunction in chronic obstructive pulmonary disease. A statement of the American Thoracic Society and European Respiratory Society.

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              Test-retest reliability of trunk accelerometric gait analysis.

              The purpose of this study was to determine the test-retest reliability of a trunk accelerometric gait analysis in healthy subjects. Accelerations were measured during walking using a triaxial accelerometer mounted on the lumbar spine of the subjects. Six men and 14 women (mean age 35.2; range 18-57) underwent the same protocol on 2 consecutive days. The raw acceleration signals from six self-selected walking speeds were transformed into a horizontal-vertical coordinate system to remove unwanted variability caused by gravity. Acceleration root mean square values, cadences, step and stride lengths were then computed and interpolated using quadratic curve fits and point estimates were calculated at a standardised walking speed of 1.35 m/s. Relative reliability was determined using two models of intraclass correlation coefficients (ICC(1,1) and ICC(3,1)) to assess any systematic shifts and absolute reliability was determined using measurement error (ME). The results of the study showed high ICC values (0.77-0.96) and ME values of 0.007-0.01 g for mean acceleration; 0.009 m for step lengths; 0.022 m for stride length and 1.644 step/min for cadences. In conclusion, the method was found to be reliable and may have a definite potential in clinical gait analysis. Copyright 2003 Elsevier B.V.

                Author and article information

                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                07 December 2018
                : 13
                : 3957-3962
                [1 ]Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan, terui@
                [2 ]Department of Rehabilitation Medicine, Akita City Hospital, Akita, Japan
                [3 ]Department of Rehabilitation, Akita Prefectural Center for Rehabilitation and Psychiatric Medicine, Daisen, Japan
                [4 ]Geriatric Health Services Facility Nikonikoen, Akita, Japan
                Author notes
                Correspondence: Yoshino Terui, Department of Physical Therapy, Akita University Graduate School of Health Sciences, 1-1-1 Hondo, Akita 010-8543, Japan, Tel +81 18 884 6504 ext 6527, Fax +81 18 884 6500, Email terui@
                © 2018 Terui et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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