Pain linked to balance, gait issues in COPD

Individuals with chronic obstructive pulmonary disease (COPD) appear to have poor balance and slower gait speed in the presence of pain, according to a study.

The study included 43 adults with COPD, among whom 25 (mean age 70 years, 40 percent female, mean BMI 29 kg/m², mean pack years 51) had persistent pain (≥3 months), and 18 (mean age 68 years, 61 percent female, mean BMI 27 kg/m², mean pack years 44) had no pain (control).

All participants underwent assessments for pain (The Brief Pain Inventory – Short Form), balance (Balance Evaluations Systems Test [BESTest] and the Berg Balance Scale [BBS]), gait (GAITrite), isokinetic hip, knee and ankle strength, lower limb muscle endurance (30-s sit-to-stand test), physical activity (Physical Activity Scale for the Elderly), and Maximal Inspiratory Pressure (Pimax).

Compared with the control group, the pain group had 14-percent lower BESTest scores (95 percent confidence interval [CI], 7.4–20.6) and 3-percent lower BBS scores (95 percent CI, 0.7–5.3). Additionally, mean gait speed was slower in the pain group than in the control group (0.99 vs 1.18 m/s, 95 percent CI for difference, 0.03–0.35; group main effect: p=0.02).

Of note, additional cognitive demands further reduced walking speed in the pain group, as indicated by a greater reduction in gait speed during the dual-task vs single-task condition (0.12 vs 0.05 m/s; interaction effect: p=0.045).

Risk factors for lower BESTest scores included poorer muscle endurance (r, 0.650), pain severity (r, –0.584), and weaker hip abductors (r, 0.370) and ankle plantar-flexors (r, 0.438).

The findings highlight the need to assess and manage pain in people with COPD in order to prevent falls.