title: Neurophysiological aspects and their relationship to clinical and functional impairment in patients with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  The purpose was to assess functional (balance L-L and A-P displacement, sit-to-stand test (SST) and Tinetti scale - balance and gait) and neurophysiological aspects (patellar and Achilles reflex and strength) relating these responses to the BODE Index.
  
  
  BACKGROUND
  The neurophysiological alterations found in patients with chronic obstructive pulmonary disease (COPD) are associated with the severity of the disease. There is also involvement of peripheral muscle which, in combination with neurophysiological impairment, may further compromise the functional activity of these patients.
  
  
  METHODS
  A cross-sectional study design was used. Twenty-two patients with moderate to very severe COPD (> 60 years) and 16 age-matched healthy volunteers served as the control group (CG). The subjects performed spirometry and several measures of static and dynamic balance, monosynaptic reflexes, peripheral muscle strength, SST and the 6-minute walk test.
  
  
  RESULTS
  The individuals with COPD had a reduced reflex response, 36.77 ± 3.23 (p < 0.05) and 43.54 ± 6.60 (p < 0.05), achieved a lower number repetitions on the SST 19.27 ± 3.88 (p < 0.05), exhibited lesser peripheral muscle strength on the femoral quadriceps muscle, 24.98 ± 6.88 (p < 0.05) and exhibited deficits in functional balance and gait on the Tinetti scale, 26.86 ± 1.69 (p < 0.05), compared with the CG. The BODE Index demonstrated correlations with balance assessment (determined by the Tinetti scale), r = 0.59 (p < 0.05) and the sit-to-stand test, r = 0.78 (p < 0.05).
  
  
  CONCLUSIONS
  The individuals with COPD had functional and neurophysiological alterations in comparison with the control group. The BODE Index was correlated with the Tinetti scale and the SST. Both are functional tests, easy to administer, low cost and feasible, especially the SST. These results suggest a worse prognosis; however, more studies are needed to identify the causes of these changes and the repercussions that could result in their activities of daily living.
authors: Nove de Julho University, São Paulo, São Paulo, Brazil. carolcmiranda@uol.com.br
authors: Carolina Chiusoli de Miranda
authors: CC
authors: Rocco
authors: Luciana Maria Malosá
authors: LM
authors: Sampaio
authors: Roberto
authors: R
authors: Stirbulov
authors: João Carlos Ferrari
authors: JC
authors: Corrêa
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000402:Airway Obstruction / Q000503:physiopathology; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D004856:Postural Balance / Q000502:physiology; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012023:Reflex, Monosynaptic / Q000502:physiology; D013147:Spirometry; D018709:Statistics, Nonparametric; D016138:Walking / Q000502:physiology