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Proprioceptive changes impair balance control in individuals with chronic obstructive pulmonary disease.

Janssens L, Brumagne S, McConnell AK, Claeys K, Pijnenburg M, Burtin C, Janssens W, Decramer M, Troosters T - PLoS ONE (2013)

Bottom Line: Compared to controls, individuals with COPD showed an increased posterior body sway during ankle muscle vibration (p = 0.047), decreased anterior body sway during back muscle vibration (p = 0.025), and increased posterior body sway during simultaneous ankle-muscle vibration (p = 0.002).Individuals with COPD, especially those with inspiratory muscle weakness, increased their reliance on ankle muscle proprioceptive signals and decreased their reliance on back muscle proprioceptive signals during balance control, resulting in a decreased postural stability compared to healthy controls.These proprioceptive changes may be due to an impaired postural contribution of the inspiratory muscles to trunk stability.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Sciences, University of Leuven, KU Leuven, Leuven, Belgium. Lotte.Janssens@faber.kuleuven.be

ABSTRACT

Introduction: Balance deficits are identified as important risk factors for falling in individuals with chronic obstructive pulmonary disease (COPD). However, the specific use of proprioception, which is of primary importance during balance control, has not been studied in individuals with COPD. The objective was to determine the specific proprioceptive control strategy during postural balance in individuals with COPD and healthy controls, and to assess whether this was related to inspiratory muscle weakness.

Methods: Center of pressure displacement was determined in 20 individuals with COPD and 20 age/gender-matched controls during upright stance on an unstable support surface without vision. Ankle and back muscle vibration were applied to evaluate the relative contribution of different proprioceptive signals used in postural control.

Results: Individuals with COPD showed an increased anterior-posterior body sway during upright stance (p = 0.037). Compared to controls, individuals with COPD showed an increased posterior body sway during ankle muscle vibration (p = 0.047), decreased anterior body sway during back muscle vibration (p = 0.025), and increased posterior body sway during simultaneous ankle-muscle vibration (p = 0.002). Individuals with COPD with the weakest inspiratory muscles showed the greatest reliance on ankle muscle input when compared to the stronger individuals with COPD (p = 0.037).

Conclusions: Individuals with COPD, especially those with inspiratory muscle weakness, increased their reliance on ankle muscle proprioceptive signals and decreased their reliance on back muscle proprioceptive signals during balance control, resulting in a decreased postural stability compared to healthy controls. These proprioceptive changes may be due to an impaired postural contribution of the inspiratory muscles to trunk stability. Further research is required to determine whether interventions such as proprioceptive training and inspiratory muscle training improve postural balance and reduce the fall risk in individuals with COPD.

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Related in: MedlinePlus

Proprioceptive control strategy.Center of pressure displacement (mean ± SD) in the control group (black) and COPD group (white) during vibration on ankle muscles, back muscles, and simultaneously on ankle and back muscles. Positive values indicate an anterior body sway, negative values indicate a posterior body sway.
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pone-0057949-g003: Proprioceptive control strategy.Center of pressure displacement (mean ± SD) in the control group (black) and COPD group (white) during vibration on ankle muscles, back muscles, and simultaneously on ankle and back muscles. Positive values indicate an anterior body sway, negative values indicate a posterior body sway.

Mentions: Figure 3 compares proprioceptive postural control for all vibration trials. Individuals with COPD showed an increased reliance on ankle proprioceptive signals during postural control as shown by a larger posterior body sway (−10.4±4.1 cm) during ankle muscle vibration compared to controls (−7.6±4.4 cm) (p = 0.047). This was corroborated by the finding that the COPD group showed a lower reliance on back muscle signals to maintain balance, as anterior body sway (3.0±2.4 cm) during back muscle vibration was reduced compared to controls (6.2±2.2 cm) (p = 0.025). Simultaneous ankle-back muscle vibration elicited significantly larger posterior body sways in individuals with COPD (−7.6±3.7 cm) compared to controls (−3.8±3.2 cm) (p = 0.002), indicative of a dominant use of ankle proprioceptive signals during postural control.


Proprioceptive changes impair balance control in individuals with chronic obstructive pulmonary disease.

Janssens L, Brumagne S, McConnell AK, Claeys K, Pijnenburg M, Burtin C, Janssens W, Decramer M, Troosters T - PLoS ONE (2013)

Proprioceptive control strategy.Center of pressure displacement (mean ± SD) in the control group (black) and COPD group (white) during vibration on ankle muscles, back muscles, and simultaneously on ankle and back muscles. Positive values indicate an anterior body sway, negative values indicate a posterior body sway.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585868&req=5

pone-0057949-g003: Proprioceptive control strategy.Center of pressure displacement (mean ± SD) in the control group (black) and COPD group (white) during vibration on ankle muscles, back muscles, and simultaneously on ankle and back muscles. Positive values indicate an anterior body sway, negative values indicate a posterior body sway.
Mentions: Figure 3 compares proprioceptive postural control for all vibration trials. Individuals with COPD showed an increased reliance on ankle proprioceptive signals during postural control as shown by a larger posterior body sway (−10.4±4.1 cm) during ankle muscle vibration compared to controls (−7.6±4.4 cm) (p = 0.047). This was corroborated by the finding that the COPD group showed a lower reliance on back muscle signals to maintain balance, as anterior body sway (3.0±2.4 cm) during back muscle vibration was reduced compared to controls (6.2±2.2 cm) (p = 0.025). Simultaneous ankle-back muscle vibration elicited significantly larger posterior body sways in individuals with COPD (−7.6±3.7 cm) compared to controls (−3.8±3.2 cm) (p = 0.002), indicative of a dominant use of ankle proprioceptive signals during postural control.

Bottom Line: Compared to controls, individuals with COPD showed an increased posterior body sway during ankle muscle vibration (p = 0.047), decreased anterior body sway during back muscle vibration (p = 0.025), and increased posterior body sway during simultaneous ankle-muscle vibration (p = 0.002).Individuals with COPD, especially those with inspiratory muscle weakness, increased their reliance on ankle muscle proprioceptive signals and decreased their reliance on back muscle proprioceptive signals during balance control, resulting in a decreased postural stability compared to healthy controls.These proprioceptive changes may be due to an impaired postural contribution of the inspiratory muscles to trunk stability.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Sciences, University of Leuven, KU Leuven, Leuven, Belgium. Lotte.Janssens@faber.kuleuven.be

ABSTRACT

Introduction: Balance deficits are identified as important risk factors for falling in individuals with chronic obstructive pulmonary disease (COPD). However, the specific use of proprioception, which is of primary importance during balance control, has not been studied in individuals with COPD. The objective was to determine the specific proprioceptive control strategy during postural balance in individuals with COPD and healthy controls, and to assess whether this was related to inspiratory muscle weakness.

Methods: Center of pressure displacement was determined in 20 individuals with COPD and 20 age/gender-matched controls during upright stance on an unstable support surface without vision. Ankle and back muscle vibration were applied to evaluate the relative contribution of different proprioceptive signals used in postural control.

Results: Individuals with COPD showed an increased anterior-posterior body sway during upright stance (p = 0.037). Compared to controls, individuals with COPD showed an increased posterior body sway during ankle muscle vibration (p = 0.047), decreased anterior body sway during back muscle vibration (p = 0.025), and increased posterior body sway during simultaneous ankle-muscle vibration (p = 0.002). Individuals with COPD with the weakest inspiratory muscles showed the greatest reliance on ankle muscle input when compared to the stronger individuals with COPD (p = 0.037).

Conclusions: Individuals with COPD, especially those with inspiratory muscle weakness, increased their reliance on ankle muscle proprioceptive signals and decreased their reliance on back muscle proprioceptive signals during balance control, resulting in a decreased postural stability compared to healthy controls. These proprioceptive changes may be due to an impaired postural contribution of the inspiratory muscles to trunk stability. Further research is required to determine whether interventions such as proprioceptive training and inspiratory muscle training improve postural balance and reduce the fall risk in individuals with COPD.

Show MeSH
Related in: MedlinePlus