Balance is impaired in people with chronic obstructive pulmonary disease

Background: It has recently been suggested that people with chronic obstructive pulmonary disease have an increased risk of falls. Although falls risk is multifactorial, impaired balance may contribute. The primary aim of this study was to compare balance between people with and without chronic obstructive pulmonary disease and the secondary aim was to determine if balance deteriorates when respiratory demand is increased by upper limb exercise.

Methods: Twelve people with chronic obstructive pulmonary disease and 12 healthy control subjects participated in this study. Participants stood on a force plate to record centre of pressure displacement during a range of conditions that challenge balance. Lumbar spine and hip motion were measured with inclinometers. Balance trials were performed before and after participation in upper limb exercise that increased respiratory demand in those with chronic obstructive pulmonary disease.

Findings: People with chronic obstructive pulmonary disease had increased mediolateral centre of pressure displacement and increased angular motion of the hip compared to healthy controls. Mediolateral centre of pressure displacement was further increased in people with chronic obstructive pulmonary disease following exercise, but unchanged in controls. Anteroposterior centre of pressure displacement did not differ between groups.

Interpretation: People with chronic obstructive pulmonary disease have reduced control of balance in the mediolateral direction. This may contribute to an increased risk of falls in this population.