title: Static and Functional Balance in Individuals With COPD: Comparison With Healthy Controls and Differences According to Sex and Disease Severity.
abstract: BACKGROUND
  Studies have shown that individuals with COPD have impaired body balance, probably caused by the disease's multisystemic manifestations plus age-related decline in balance, potentially increasing the risk of falling and its consequences. However, little is known about the profile of individuals with COPD who present balance impairments, especially related to sex and disease severity stages. The aim of this work was to compare static and functional balance between subjects with COPD and healthy controls and to check possible differences according to sex and degrees of disease severity.
  
  
  METHODS
  Forty-seven subjects with COPD and 25 healthy controls were included in this study. Their static balance was assessed in one-legged stance using a force platform and functional balance with the Timed Up and Go test. Additionally, participants performed spirometry, the 6-min walk test and isometric quadriceps maximal voluntary contraction assessment. Disease severity was classified according to the Global Initiative for Obstructive Lung Disease stages and BODE (body mass index, air-flow obstruction, dyspnea, and exercise capacity) scores.
  
  
  RESULTS
  In comparison with healthy controls, subjects with COPD had worse static (center of pressure displacement area: 9.3 ± 1.9 cm2vs 11.6 ± 4.0 cm2, respectively, P = .01) and functional balance (Timed Up and Go test: 8.5 ± 1.3 s vs 10.3 ± 1.8 s, respectively, P < .001). In the COPD group, men performed better in the Timed Up and Go test than women (9.8 ± 1.2 s vs 10.9 ± 2.2 s, respectively, P = .03), whereas women presented a better static balance in comparison with men for all parameters related to center of pressure (P < .005 for all). Disease severity did not affect any balance results.
  
  
  CONCLUSIONS
  Individuals with COPD had worse static and functional balance in comparison with healthy controls. Sex can mediate these results, depending on the type of balance evaluation (force platform or functional test). Balance performance was similar among the groups classified according to disease severity.
authors.affiliation: Research Centre in Health Sciences (CPCS), University of Northern Parana (UNOPAR), Londrina, Brazil.|Laboratory of Research in Respiratory Physiotherapy (LFIP), Physiotherapy Department, Londrina State University (UEL), Londrina, Brazil.
authors.forename: Larissa A
authors.initials: LA
authors.lastname: de Castro
authors.affiliation: Research Centre in Health Sciences (CPCS), University of Northern Parana (UNOPAR), Londrina, Brazil.
authors.forename: Laís Rg
authors.initials: LR
authors.lastname: Ribeiro
authors.affiliation: Laboratory of Research in Respiratory Physiotherapy (LFIP), Physiotherapy Department, Londrina State University (UEL), Londrina, Brazil.|Department of Research and Education, CIRO, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.|Department of Respiratory Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands.
authors.forename: Rafael
authors.initials: R
authors.lastname: Mesquita
authors.affiliation: Laboratory of Research in Respiratory Physiotherapy (LFIP), Physiotherapy Department, Londrina State University (UEL), Londrina, Brazil.
authors.forename: Débora R
authors.initials: DR
authors.lastname: de Carvalho
authors.affiliation: Research Centre in Health Sciences (CPCS), University of Northern Parana (UNOPAR), Londrina, Brazil.
authors.forename: Josiane M
authors.initials: JM
authors.lastname: Felcar
authors.affiliation: Research Centre in Health Sciences (CPCS), University of Northern Parana (UNOPAR), Londrina, Brazil.
authors.forename: Myriam F
authors.initials: MF
authors.lastname: Merli
authors.affiliation: Research Centre in Health Sciences (CPCS), University of Northern Parana (UNOPAR), Londrina, Brazil.
authors.forename: Karen Bp
authors.initials: KB
authors.lastname: Fernandes
authors.affiliation: Research Centre in Health Sciences (CPCS), University of Northern Parana (UNOPAR), Londrina, Brazil.
authors.forename: Rubens A
authors.initials: RA
authors.lastname: da Silva
authors.affiliation: Research Centre in Health Sciences (CPCS), University of Northern Parana (UNOPAR), Londrina, Brazil.|Centre for Physical Education and Sports, Department of Physical Education, Londrina State University (UEL), Londrina, Brazil.
authors.forename: Denilson C
authors.initials: DC
authors.lastname: Teixeira
authors.affiliation: Department of Research and Education, CIRO, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.|REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Spruit
authors.affiliation: Laboratory of Research in Respiratory Physiotherapy (LFIP), Physiotherapy Department, Londrina State University (UEL), Londrina, Brazil.
authors.forename: Fabio
authors.initials: F
authors.lastname: Pitta
authors.affiliation: Research Centre in Health Sciences (CPCS), University of Northern Parana (UNOPAR), Londrina, Brazil. vanessaprobst@gmail.com.|Laboratory of Research in Respiratory Physiotherapy (LFIP), Physiotherapy Department, Londrina State University (UEL), Londrina, Brazil.
authors.forename: Vanessa S
authors.initials: VS
authors.lastname: Probst
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D004856:Postural Balance / Q000502:physiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D052097:Quadriceps Muscle / Q000503:physiopathology; D012307:Risk Factors; D012678:Sensation Disorders / Q000209:etiology; D012720:Severity of Illness Index; D012737:Sex Factors; D013147:Spirometry; D000070857:Walk Test
keywords: COPD; accidental falls; disability evaluation; postural balance; risk factors; symptoms