Subjects With COPD Walk With Less Consistent Organization of Movement Patterns of the Lower Extremity

BACKGROUND: The inherent stride-to-stride fluctuations during walking are altered in the aging population and could provide insight into gait impairments and falls in patients with COPD. Stride-to-stride fluctuations are quantified two ways: variability of the fluctuations (eg, standard deviation), and movement patterns within the fluctuations. Our objective was to investigate stride-to-stride fluctuations by evaluating the variability and movement patterns of lower limb joints in subjects with COPD compared to subjects without COPD as control subjects.

METHODS: In this cross-sectional study, 22 subjects with COPD (age 63 ± 9 y; FEV₁ 54 ± 19% predicted) and 22 control subjects (age 62 ± 9 y; FEV₁ 95 ± 18% predicted) walked for 3 min on a treadmill while their gait was recorded. The amount of variability (ie, standard deviation and coefficient of variation) and movement patterns (ie, predictability and consistency in organization) were quantified for the range of motion and joint angle of the hip, knee, and ankle, at 3 walking speeds (ie, self-selected, fast, and slow). General linear mixed models were used for analysis.

RESULTS: Control subjects had more consistent organization of the hip and knee joint movement patterns compared to subjects with COPD (P = .02 and P = .02, respectively). Further, control subjects adapted to speed changes by demonstrating more consistent organization of movement patterns with faster speeds, whereas subjects with COPD did not. At the fast walking speed, subjects with COPD demonstrated less consistent organization of knee and hip joint movement patterns as compared to control subjects without COPD (P = .03 and P = .005, respectively). The amount of variability did not differ between groups.

CONCLUSIONS: Although subjects with COPD did not demonstrate decreased amount of variability, their hip and knee joint movement patterns were less consistent in organization during walking. Reduced consistency in organization of movement patterns may be a contributing factor to falls and mobility problems experienced by patients with COPD.