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Research Articles

Age and Sex Differences in Balance Outcomes among Individuals with Chronic Obstructive Pulmonary Disease (COPD) at Risk of Falls

Sanaa A. Alsubheena School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada;b Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, CanadaCorrespondence[email protected]

https://orcid.org/0000-0001-9841-7522

Marla Beauchampa School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada;b Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada

https://orcid.org/0000-0003-2843-388X

Cindy Ellertonb Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada;c Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

Roger Goldsteinb Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada;c Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada;d Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada;e Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

Jennifer Alisonf School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia

https://orcid.org/0000-0002-2011-4756

Gail Dechmang School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada;h Department of Medicine, Respirology, Dalhousie University and Nova Scotia Health Authority, Halifax, NS, Canada

Kimberley J. Hainesi Physiotherapy Department, Western Health, Melbourne, VIC, Australia

Samantha Harrisonj School of Health and Social Care, Teesside University, Middlesbrough, UK

Anne Hollandk Department of Physiotherapy, Alfred Health, Melbourne, VIC, Australia;l Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, VIC, Australia;m Respiratory Research, Monash University, Melbourne, VIC, Australia;n Institute for Breathing and Sleep, Melbourne, VIC, Australia

https://orcid.org/0000-0003-2061-845X

Annemarie Leen Institute for Breathing and Sleep, Melbourne, VIC, Australia;o Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia;p Centre for Allied Health Research and Education, Cabrini Health, Malvern, VIC, Australia

Alda Marquesq Lab3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA) and Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal

Lissa Spencerr Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, NSW, Australia

https://orcid.org/0000-0002-2358-0736

Michael Sticklands Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;t G.F. MacDonald Centre for Lung Health, Covenant Health, Edmonton, AB, Canada

Elizabeth H. Skinneri Physiotherapy Department, Western Health, Melbourne, VIC, Australia;n Institute for Breathing and Sleep, Melbourne, VIC, Australia

https://orcid.org/0000-0003-0268-7160

Dina Brooksl Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, VIC, Australia;c Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada;d Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada;e Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

https://orcid.org/0000-0001-6080-5052

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Abstract

No previous research has examined age and sex differences in balance outcomes in individuals with chronic obstructive pulmonary disease (COPD) at risk of falls. A secondary analysis of baseline data from an ongoing trial of fall prevention in COPD was conducted. Age and sex differences were analyzed for the Berg Balance scale (BBS), Balance Evaluation System Test (BEST test) and Activities-specific Balance Confidence Scale (ABC). Overall, 223 individuals with COPD were included. Females had higher balance impairments than males [BBS: mean (SD) = 47 (8) vs. 49 (6) points; BEST test: 73 (16) vs. 80 (16) points], and a lower confidence to perform functional activities [ABC = 66 (21) vs. 77 (19)]. Compared to a younger age (50–65 years) group, age >65 years was moderately associated with poor balance control [BBS (r = − 0.37), BEST test (r = − 0.33)] and weakly with the ABC scale (r = − 0.13). After controlling for the effect of balance risk factors, age, baseline dyspnea index (BDI), and the 6-min walk test (6-MWT) explained 38% of the variability in the BBS; age, sex, BDI, and 6-MWT explained 40% of the variability in the BEST test; And BDI and the 6-MWT explained 44% of the variability in the ABC scale. This study highlights age and sex differences in balance outcomes among individuals with COPD at risk of falls. Recognition of these differences has implications for pulmonary rehabilitation and fall prevention in COPD, particularly among females and older adults.

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Acknowledgments

Dr. Dina Brooks holds the National Sanitarium Association (NSA) Chair in Respiratory Rehabilitation Research. Dr. Marla Beauchamp holds a Canada Research Chair in Mobility, Aging, and Chronic Disease. This study was funded by the Canadian Institute of Health Research (CIHR funding reference # PJT 148566).

Declaration of Interest

All authors declare no conflict of interest.

Funding

This study was funded by the Canadian Institute of Health Research (CIHR funding reference # PJT 148566).

Age and Sex Differences in Balance Outcomes among Individuals with Chronic Obstructive Pulmonary Disease (COPD) at Risk of Falls

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Age and Sex Differences in Balance Outcomes among Individuals with Chronic Obstructive Pulmonary Disease (COPD) at Risk of Falls

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