Which Balance Subcomponents Distinguish Between Fallers and Non-Fallers in People with COPD?

Abstract

Rationale

Chronic obstructive pulmonary disease (COPD) is an increasingly prevalent lung disease linked to dysfunctional balance and an increased risk of falls. The Balance Evaluation Systems Test (BESTest) evaluates the six underlying subcomponents of functional balance. The aim of this study was to determine the specific balance subcomponents and cut-off scores that discriminate between fallers and non-fallers with COPD to guide fall risk assessment and prevention.

Methods

A secondary analysis of cross-sectional data from two prior studies in COPD was performed. Independent samples t-tests were used to explore the differences in the BESTest sub-system scores between fallers and non-fallers. Receiver operating characteristic curves were used to determine the optimal subcomponent cut-off scores that identified fallers, and the area under the curve (AUC) was used to assess test accuracy.

Results

Data from 72 subjects with COPD (mean age, 70.3 ± 7.4y; mean forced expiratory volume in 1 second, 38.9 ± 15.8% predicted) were analyzed. Two BESTest subcomponents, stability limits/verticality (fallers: 75.4%, non-fallers: 83.8%; p=0.002) and postural responses (fallers: 67.5%, non-fallers: 79.7%; p=0.008) distinguished between fallers and non-fallers. Stability limits/verticality had an AUC of 0.70 and optimal cut-off score of 73.8% for identifying fallers; postural responses had an AUC of 0.67 and optimal cut-off score of 69.4%.

Conclusion

The stability limits/verticality and postural responses subcomponents of the BESTest distinguished between fallers and non-fallers with COPD. The stability limits/verticality subcomponent can also be used to identify whether an individual with COPD is at risk of falling using a cut-off score of 73.8%. These findings suggest that specific subcomponents of balance could be targeted to optimize fall risk assessment and prevention in COPD.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): COPD

Journal ID (pmc): copd

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date (Electronic): 01 July 2020

Publication date Collection: 2020

Volume: 15

Pages: 1557-1564

Affiliations

[1 ]School of Rehabilitation Science, McMaster University , Hamilton, Ontario, Canada

[2 ]Department of Respiratory Medicine, West Park Healthcare Centre , Toronto, Ontario, Canada

[3 ]Department of Physical Therapy, University of Toronto , Toronto, Ontario, Canada

[4 ]Department of Medicine, University of Toronto , Toronto, Ontario, Canada

[5 ]Firestone Institute for Respiratory Health, St. Joseph’s Healthcare , Hamilton, Ontario, Canada

Author notes

Correspondence: Marla K Beauchamp McMaster University , 1400 Main Street West, Hamilton, ONL8S 1C7, IAHS 430CanadaTel [phone] x 21732 Email [e-mail]

Article

Publisher ID: 253561

DOI: 10.2147/COPD.S253561

PMC ID: 7335868

Copyright statement: © 2020 Chauvin et al.

License:

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Page count

Figures: 2, Tables: 4, References: 30, Pages: 8

Funding

Funded by: Emerging Research Leaders Initiative from the Canadian Respiratory Research Network

Funded by: Labarge Mobility Scholarship from the McMaster Institute for Research on Aging

Funded by: Canadian Institutes of Health Research 10.13039/501100000024

M Beauchamp is supported by an Emerging Research Leaders Initiative from the Canadian Respiratory Research Network. S Chauvin is supported by a Labarge Mobility Scholarship from the McMaster Institute for Research on Aging, and a Canada Graduate Scholarship-Master’s from the Canadian Institutes of Health Research. D Brooks holds a National Sanitarium Chair in Respiratory Rehabilitation.

Categories

Subject: Original Research