title: Balance is impaired in people with chronic obstructive pulmonary disease.
abstract: 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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Clinical Centre of Research Excellence in Spinal Pain, Injury and Health, The University of Queensland, Division of Physiotherapy, School of Health and Rehabilitation Sciences, St. Lucia, Queensland 4072, Australia. m.smith5@uq.edu.au
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Smith
authors.forename: Angela T
authors.initials: AT
authors.lastname: Chang
authors.forename: Helen E
authors.initials: HE
authors.lastname: Seale
authors.forename: James R
authors.initials: JR
authors.lastname: Walsh
authors.forename: Paul W
authors.initials: PW
authors.lastname: Hodges
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012129:Respiratory Function Tests