title: Gait patterns in COPD: the Rotterdam Study.
abstract: 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.
authors.affiliation: Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium Dept of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands These authors contributed equally.
authors.forename: Lies
authors.initials: L
authors.lastname: Lahousse
authors.affiliation: Dept of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands Dept of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands These authors contributed equally.
authors.forename: Vincentius J A
authors.initials: VJ
authors.lastname: Verlinden
authors.affiliation: Dept of Neuroscience, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Jos N
authors.initials: JN
authors.lastname: van der Geest
authors.affiliation: Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Guy F
authors.initials: GF
authors.lastname: Joos
authors.affiliation: Dept of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands Members of the Netherlands Consortium on Healthy Aging, Leiden, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Dept of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands Members of the Netherlands Consortium on Healthy Aging, Leiden, The Netherlands Dept of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands Inspectorate of Healthcare, The Hague, The Netherlands b.stricker@erasmusmc.nl.
authors.forename: Bruno H C
authors.initials: BH
authors.lastname: Stricker
authors.affiliation: Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium Dept of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands Dept of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Guy G
authors.initials: GG
authors.lastname: Brusselle
authors.affiliation: Dept of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands Dept of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands Dept of Neuroscience, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D004417:Dyspnea / Q000150:complications; D005260:Female; D005541:Forced Expiratory Volume; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012907:Smoking; D013147:Spirometry; D014797:Vital Capacity; D016138:Walking