Validity of balance and mobility screening tests for assessing fall risk in COPD

McLay, Rachel; Kirkwood, Renata Noce; Kuspinar, Ayse; Richardson, Julie; Wald, Joshua; Raghavan, Natya; Ellerton, Cindy; Pugsley, Stewart O.; Beauchamp, Marla K.

doi:10.1177/1479973120922538

Cited by 20 publications

(19 citation statements)

References 40 publications

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“…The TUG test has been reported to identify patients at risk for falls due to cognitive impairment [48]. However, in disagreement with other studies [47,49,50,51], our multivariable analysis revealed that the TUG tests were not independently associated with the risk of falls in older adults living in the UAE. Herman et al (2009) stated that the DGI is a very important test in predicting the risk of fall for older adults as it measures the gait instability and evaluates not only usual walking, but also walking during more challenging tasks as a demand of changing the position during walking [52].…”

Section: Discussioncontrasting

confidence: 95%

Association between demographic characteristics, lower limb range of motion, functional performance, ability to dual task, quality of life and risk of falls in older adults of the United Arab Emirates - A cross-sectional study

Alzaabi

Walton

Arumugam

2022

Heliyon

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Background: With increasing age, decreased range of motion of lower limb joints, impaired functional performance and balance, pain status, altered dual tasking, and poor quality of life may predict the risk for falls in older adults. Therefore, this study aimed to identify which of the aforementioned variables and demographic factors predict falls in older adults in the United Arab Emirates. In addition, the study examined the association between demographic characteristics and the risk of falls in older adults. Methods: This cross-sectional study included 100 (50 women) community-dwelling older adults (age: 75 AE 3.6 years). Participant demographic characteristics (sex, age, body mass index, limb dominance, exercise status, etc.) were documented. The independent variables included the outcomes of demographic characteristics, active range of motion of the hip, knee, and ankle, single-leg stance, five times sit-to-stand, timed up and go test, dynamic gait index, pain, and World Health Organization Quality of Life Assessment-Bref questionnaire. The dependent variable was the risk of falls (self-reported presence or absence of falls) in the past 12 months. Results: Out of 100 older adults, forty-two reported a fall and among them 26 were women. Many of the independent variables were significantly associated with the risk of falls in univariate analysis. However, multivariable logistic regression revealed that none of them were independently associated with the risk of falls in older adults living in the United Arab Emirates. Conclusions: Relying specifically on one of the included variables as an independent (risk) factor associated with falls in older adults of the United Arab Emirates warrants further investigation.

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Section: Discussioncontrasting

confidence: 95%

Association between demographic characteristics, lower limb range of motion, functional performance, ability to dual task, quality of life and risk of falls in older adults of the United Arab Emirates - A cross-sectional study

Alzaabi

Walton

Arumugam

2022

Heliyon

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“…Minimal floor effects were found in patients severe-COVID and CLD, similar to previous findings in patients with COPD at 1 month after hospital discharge. 39 However, 14% of critical-COVID survivors were unable to perform the TUG or DT-TUG 1-month post discharge. Additionally, the MDC values reported here are of substantial value to clinical determinates of DT performance across time, or future intervention studies aiming to develop targeted rehabilitation strategies to address DT deficits in COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Patients Surviving Critical COVID-19 have Impairments in Dual-task Performance Related to Post-intensive Care Syndrome

Morelli

Parry

Steele

et al. 2022

J Intensive Care Med

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Objective The purpose was to examine Dual Task (DT) performance in patients surviving severe and critical COVID-19 compared to patients with chronic lung disease (CLD). Secondarily, we aimed to determine the psychometric properties of the Timed Up and Go (TUG) test in patients surviving COVID-19. Design Prospective, cross-sectional, observational study. Setting Academic medical center within United States. Patients Ninety-two patients including 36 survivors of critical COVID-19 that required mechanical ventilation (critical-COVID), 20 patients recovering from COVID-19 that required supplemental oxygen with hospitalization (severe-COVID), and 36 patients with CLD serving as a control group. Measurements and Main Results Patients completed the TUG, DT-TUG, Short Physical Performance Battery (SPPB), and Six Minute Walk Test (6MWT) 1-month after hospital discharge. A subset of patients returned at 3-months and repeated testing to determine the minimal detectable change (MDC). Critical-COVID group (16.8 ± 7.3) performed the DT-TUG in significantly slower than CLD group (13.9 ± 4.8 s; P = .024) and Severe-COVID group (13.1 ± 5.1 s; P = .025). Within-subject difference between TUG and DT-TUG was also significantly worse in critical-COVID group (−21%) compared to CLD (−10%; P = .012), even despite CLD patients having a higher comorbid burden ( P < .003) and older age ( P < .001). TUG and DT-TUG demonstrated strong to excellent construct validity to the chair rise test, gait speed, and 6MWT for both COVID-19 groups (r = −0.84to 0.73, P < .05). One- and 3-months after hospital discharge there was a floor effect of 14% (n = 5/36) and 5.2% (n = 1/19), respectively for patients in the critical-COVID group. Ceiling effects were noted in four (11%) critical-COVID, six (30%) severe-COVID patients for the TUG and DT-TUG at 1-month. Conclusion The ability to maintain mobility performance in the presence of a cognitive DT is grossly impaired in patients surviving critical COVID-19. DT performance may subserve the understanding of impairments related to Post-intensive care syndrome (PICS) for survivors of critical illness.

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“…The SLS was performed three times with a pause between repetitions, and the best value was recorded [ 39 ]. The SLS test is a valid test in COPD that can indicate fall risk in COPD [ 40 ]. Values <30 s with open eyes indicated impaired balance in the general population > 60 years old [ 35 ].…”

Section: Methodsmentioning

confidence: 99%

Effects of specific inspiratory muscle training combined with whole-body endurance training program on balance in COPD patients: Randomized controlled trial

et al. 2021

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Purpose This study aims to assess the effect of inspiratory muscle training (IMT) combined with endurance training (ET) on balance in patients with chronic obstructive pulmonary disease (COPD). Methods We studied 32 male patients (62 ± 6 years) with moderate to very severe COPD. They were randomly assigned to an experimental group (IMT+ET) n = 16 or a control group (ET) n = 16 with similar characteristics. The evaluations were carried out at inclusion and after eight weeks of the training period. Functional balance was assessed by the Berg Balance Scale (BBS), the Timed-up and Go (TUG), the Single Leg Stance test (SLS), and the Activities-specific Balance Confidence (ABC) scale. The strength of the inspiratory muscles (PImax) was assessed by maximal inspiratory mouth pressure. Functional exercise performance was assessed by the 6 minutes walking test (6MWT). IMT program consists in performing two daily sets of 30 inspirations with 50% of PImax increased by 10% every two weeks. ET program consists in performing 30 min treadmill exercise at 60% to 80% of the average speed achieved during the 6MWT three days per week. Results After the training period, the experimental group demonstrated greater improvements in BBS (IMT+ET vs. ET; p = 0.019), and in ABC (IMT+ET vs. ET; p = 0.014). However, no significant differences between groups were observed for TUG, SLS, and 6MWT. There was a significant difference between groups in PImax (IMT+ET vs. ET; p = 0.030). Significant moderate correlations were obtained between ΔPImax and ΔBBS for both groups (IMT+ET: r = 0.624, p = 0.010; ET r = 0.550, p = 0.027) as well as for ΔABC but only in the experimental group (IMT+ET: r = 0.550, p = 0.027). Conclusion Compared to ET alone, the results suggest that IMT combined with ET enhances inspiratory muscle function and functional balance according to BBS and ABC in patients with COPD. We suggest that inspiratory muscle training might be introduced as additional training to pulmonary rehabilitation programs aimed at improving balance in COPD patients. Trial registration The trial registry name: Clinical Trials; Registration number: NCT04084405; URL: https://clinicaltrials.gov/ct2/show/NCT04084405.

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Validity of balance and mobility screening tests for assessing fall risk in COPD

Cited by 20 publications

References 40 publications

Association between demographic characteristics, lower limb range of motion, functional performance, ability to dual task, quality of life and risk of falls in older adults of the United Arab Emirates - A cross-sectional study

Association between demographic characteristics, lower limb range of motion, functional performance, ability to dual task, quality of life and risk of falls in older adults of the United Arab Emirates - A cross-sectional study

Patients Surviving Critical COVID-19 have Impairments in Dual-task Performance Related to Post-intensive Care Syndrome

Effects of specific inspiratory muscle training combined with whole-body endurance training program on balance in COPD patients: Randomized controlled trial

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