Determinants of Gait Speed in COPD

Karpman, Craig; DePew, Zachary S.; LeBrasseur, Nathan K.; Novotny, Paul J.; Benzo, Roberto

doi:10.1378/chest.13-2017

Cited by 54 publications

(64 citation statements)

References 46 publications

(52 reference statements)

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“…This is the first study to comprehensively investigate the associations of COPD and COPD severity with the gait pattern. A lower walking distance during a 6-min walk or shuttle walk test has been extensively reported in people with COPD; however, literature on gait velocity and other gait deficits is scarce [8,27]. Our results show that COPD is especially related with taking slower steps (lower Rhythm).…”

Section: Discussionsupporting

confidence: 49%

Gait patterns in COPD: the Rotterdam Study

et al. 2015

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Gait disturbances in patients with chronic obstructive pulmonary disease (COPD) may lead to disability and falls. As studies assessing gait kinematics in COPD are sparse, we investigated associations of COPD with various gait domains and explored a potential link with falling.Gait was measured within the prospective, population-based Rotterdam Study (age ⩾55 years) using an electronic walkway and summarised into seven gait domains: Rhythm, Variability, Phases, Pace, Tandem, Turning and Base of Support. Rhythm is a temporal gait aspect that includes cadence and reflects how quickly steps are taken.Persons with COPD (n=196) exhibited worse Rhythm (−0.21 SD, 95% CI −0.36-−0.06 SD) compared with persons with normal lung function (n=898), independent of age, sex, height, education, smoking or analgesic use, especially when dyspnoea and severe airflow limitation or frequent exacerbations (Global Initiative for Chronic Obstructive Lung Disease group D: −0.83 SD, 95% CI −1.25-−0.41 SD) were present. A lower forced expiratory volume in 1 s was associated with worse Rhythm and Pace, including lower cadence and gait velocity, respectively. Importantly, fallers with COPD had significantly worse Rhythm than nonfallers with COPD.This study demonstrates that persons with COPD exhibit worse Rhythm, especially fallers with COPD. The degree of Rhythm deterioration was associated with the degree of airflow limitation, symptoms and frequency of exacerbations. @ERSpublications This study comprehensively investigates, in a large, population-based cohort, the gait pattern in COPD http://ow.ly/HQbc3

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Section: Discussionsupporting

confidence: 49%

Gait patterns in COPD: the Rotterdam Study

et al. 2015

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“…There is a general consensus on the fact that patients with COPD walk slower in tests like the 6MWT than healthy age-matched individu als [19,28,29]. However, as speed is responsible of considerable changes in gait patterns [30], to exclude a possible confounding factor and to better identify COPD-specific characteristics, gait should be evaluated at similar speeds as done in [22,25].…”

Section: Spatiotemporal Parametersmentioning

confidence: 99%

Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review

et al. 2018

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Background: Gait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD. Research question: Thus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD. Methods: In line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool. Results: Seven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level. Significance: A convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD.

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“…Most studies 193 were classified as "fair" in the quality appraisal. The TUG was the only test which did The most widely used protocol in patients with COPD was the 4MGS, that is, the 206 required speed to walk four meters 8,[26][27][28][29] . Five studies described this protocol with some 207 specificities: usual walking speed in a 4-meter course 8,26,29 or usual and maximal speed 208 in an 8-meter course (two-meter acceleration zone, a four-meter timing area and a two-209 meter deceleration zone) 27 (Table 216 3).…”

mentioning

confidence: 99%

“…32 Mesquita et al 31 Horie et al 20 Beauchamp et al 29 Butcher et al 19 n= 85 (34.3±13.6%) n=95 (33 [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] To stand up from a chair and walk 3 meters at usual speed, turn and walk back to the chair and sit down again.…”

mentioning

confidence: 99%