Balance recovery is compromised and trunk muscle activity is increased in chronic obstructive pulmonary disease

Abstract

Please cite this article as: Smith MD, Chang AT, Hodges PW, Balance recovery is compromised and trunk muscle activity is increased in chronic obstructive pulmonary disease, Gait and Posture (2015), http://dx.doi.org/10.1016/j.gaitpost. 2015.09.004 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Abdominal muscle EMG was similar between groups, but controls had greater ES EMG during arm movements. Individuals with more severe COPD had greater OE and RA EMG both before and during arm movement compared to those with less severe COPD and controls. Following exercise, OE and ES EMG increased in people with less severe COPD.This study shows that severe COPD is associated with impaired ability to recover balance and greater trunk muscle activity during postural challenges. Augmented trunk muscle activity may limit the contribution of trunk movements to balance recovery and could contribute to increased falls risk.

Impaired calcium signaling in muscle fibers from intercostal and foot skeletal muscle in a cigarette smoke-induced mouse model of COPD

“…In support of this hypothesis, recent reports have shown that COPD in advanced stages is associated with an increased history of falls, balance impairment, and lower extremity muscle weakness. [65][66][67][68] Our results highlight that intercostal and intrinsic foot muscle Ca 21 signaling dysregulation occurs in cigarette smoke exposure. Understanding in more detail the pathophysiology of COPD and its effects in different skeletal muscles could help to further our knowledge of the natural history of the disease and to develop targeted treatments aimed to improve the performance of specific muscle groups.…”

“…We hypothesize that intrinsic foot muscle dysfunction could contribute to the increased susceptibility to falls in individuals with chronic COPD. In support of this hypothesis, recent reports have shown that COPD in advanced stages is associated with an increased history of falls, balance impairment, and lower extremity muscle weakness …”

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

“…Several reports indicated that decreases in the level of physical activity, which affect the prognosis of patients with COPD, can cause reduced balance ability 27–29. Compared with healthy individuals, COPD patients take a longer time to correct losses of balance while walking, and they require more trunk muscle activity 30. If patients with COPD fall and injure themselves, they may experience decreased physical functions, and their resulting reluctance to walk may lead to decreased levels of physical activity 31,32…”

The effect of inspiratory and expiratory loads on abdominal muscle activity during breathing in subjects “at risk” for the development of chronic obstructive pulmonary disease and healthy

“…As another point of view, this recruitment pattern of superficial abdominal muscles during breathing with respiratory loads, observed in subjects ''At Risk" for the development of COPD, may impair the postural control. The excessive trunk muscle activity, namely abdominal muscles, in response to increased respiratory demand, can compromise the trunk moments/movements (Smith et al, 2016). Therefore, the reduced contribution of trunk movement to postural control may be the source to balance deficits that were reported in COPD subjects (Janssens et al, 2013;Smith et al, 2010).…”