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Postural control in chronic obstructive pulmonary disease: a systematic review.

Porto EF, Castro AA, Schmidt VG, Rabelo HM, Kümpel C, Nascimento OA, Jardim JR - Int J Chron Obstruct Pulmon Dis (2015)

Bottom Line: Nevertheless, falls are associated to increased mortality, decreased independence and physical activity levels, and worsening of quality of life.Our study examiners found only seven studies that had a PEDro score higher than five points.Associated factors contributing to impaired postural control were muscle weakness, physical inactivity, elderly age, need for supplemental oxygen, and limited mobility.

View Article: PubMed Central - PubMed

Affiliation: Pulmonary Rehabilitation Center, Federal University of São Paulo, São Paulo, Brazil ; Adventist University, São Paulo, Brazil.

ABSTRACT

Unlabelled: Patients with chronic obstructive pulmonary disease (COPD) fall frequently, although the risk of falls may seem less important than the respiratory consequences of the disease. Nevertheless, falls are associated to increased mortality, decreased independence and physical activity levels, and worsening of quality of life. The aims of this systematic review was to evaluate information in the literature with regard to whether impaired postural control is more prevalent in COPD patients than in healthy age-matched subjects, and to assess the main characteristics these patients present that contribute to impaired postural control.

Methods: Five databases were searched with no dates or language limits. The MEDLINE, PubMed, EMBASE, Web of Science, and PEDro databases were searched using "balance", "postural control", and "COPD" as keywords. The search strategies were oriented and guided by a health science librarian and were performed on March 27, 2014. The studies included were those that evaluated postural control in COPD patients as their main outcome and scored more than five points on the PEDro scale. Studies supplied by the database search strategy were assessed independently by two blinded researchers.

Results: A total of 484 manuscripts were found using the "balance in COPD or postural control in COPD" keywords. Forty-three manuscripts appeared more than once, and 397 did not evaluate postural control in COPD patients as the primary outcome. Thus, only 14 studies had postural control as their primary outcome. Our study examiners found only seven studies that had a PEDro score higher than five points. The examiners' interrater agreement was 76.4%. Six of those studies were accomplished with a control group and one study used their patients as their own controls. The studies were published between 2004 and 2013.

Conclusion: Patients with COPD present postural control impairment when compared with age-matched healthy controls. Associated factors contributing to impaired postural control were muscle weakness, physical inactivity, elderly age, need for supplemental oxygen, and limited mobility.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of manuscript selection procedure.
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f1-copd-10-1233: Flow diagram of manuscript selection procedure.

Mentions: Figure 1 shows the manuscript selection procedure from screening to final analysis. Initially, 484 manuscripts were found using the keywords “balance in COPD” or “postural control in COPD”. Of those, 397 studies were excluded because they did not evaluate postural control in COPD patients as their main outcome and did not score more than five points on the PEDro scale. Only 14 studies had postural controls as their primary outcome.1,2,7,10,12,13–23Table 1 shows the manuscripts9,12,13,16,17,20,22 that were included in the final analysis. According to the PEDro scale, the manuscript scores ranged from six to nine points. Cross-sectional studies comprised 87.5% of the trials, and the most commonly assessed outcome variables were postural control, mobility, coordination, strength muscle, exercise tolerance, physical activity, and risk of falling. The methods most frequently used to assess the impairment of postural control were the Berg Balance Scale (BBS), the Balance Evaluation Systems Test (BESTest), the Tinetti scale, the strength platform, and posturography. Descriptions of these methods can be found elsewhere.4,18,23


Postural control in chronic obstructive pulmonary disease: a systematic review.

Porto EF, Castro AA, Schmidt VG, Rabelo HM, Kümpel C, Nascimento OA, Jardim JR - Int J Chron Obstruct Pulmon Dis (2015)

Flow diagram of manuscript selection procedure.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493971&req=5

f1-copd-10-1233: Flow diagram of manuscript selection procedure.
Mentions: Figure 1 shows the manuscript selection procedure from screening to final analysis. Initially, 484 manuscripts were found using the keywords “balance in COPD” or “postural control in COPD”. Of those, 397 studies were excluded because they did not evaluate postural control in COPD patients as their main outcome and did not score more than five points on the PEDro scale. Only 14 studies had postural controls as their primary outcome.1,2,7,10,12,13–23Table 1 shows the manuscripts9,12,13,16,17,20,22 that were included in the final analysis. According to the PEDro scale, the manuscript scores ranged from six to nine points. Cross-sectional studies comprised 87.5% of the trials, and the most commonly assessed outcome variables were postural control, mobility, coordination, strength muscle, exercise tolerance, physical activity, and risk of falling. The methods most frequently used to assess the impairment of postural control were the Berg Balance Scale (BBS), the Balance Evaluation Systems Test (BESTest), the Tinetti scale, the strength platform, and posturography. Descriptions of these methods can be found elsewhere.4,18,23

Bottom Line: Nevertheless, falls are associated to increased mortality, decreased independence and physical activity levels, and worsening of quality of life.Our study examiners found only seven studies that had a PEDro score higher than five points.Associated factors contributing to impaired postural control were muscle weakness, physical inactivity, elderly age, need for supplemental oxygen, and limited mobility.

View Article: PubMed Central - PubMed

Affiliation: Pulmonary Rehabilitation Center, Federal University of São Paulo, São Paulo, Brazil ; Adventist University, São Paulo, Brazil.

ABSTRACT

Unlabelled: Patients with chronic obstructive pulmonary disease (COPD) fall frequently, although the risk of falls may seem less important than the respiratory consequences of the disease. Nevertheless, falls are associated to increased mortality, decreased independence and physical activity levels, and worsening of quality of life. The aims of this systematic review was to evaluate information in the literature with regard to whether impaired postural control is more prevalent in COPD patients than in healthy age-matched subjects, and to assess the main characteristics these patients present that contribute to impaired postural control.

Methods: Five databases were searched with no dates or language limits. The MEDLINE, PubMed, EMBASE, Web of Science, and PEDro databases were searched using "balance", "postural control", and "COPD" as keywords. The search strategies were oriented and guided by a health science librarian and were performed on March 27, 2014. The studies included were those that evaluated postural control in COPD patients as their main outcome and scored more than five points on the PEDro scale. Studies supplied by the database search strategy were assessed independently by two blinded researchers.

Results: A total of 484 manuscripts were found using the "balance in COPD or postural control in COPD" keywords. Forty-three manuscripts appeared more than once, and 397 did not evaluate postural control in COPD patients as the primary outcome. Thus, only 14 studies had postural control as their primary outcome. Our study examiners found only seven studies that had a PEDro score higher than five points. The examiners' interrater agreement was 76.4%. Six of those studies were accomplished with a control group and one study used their patients as their own controls. The studies were published between 2004 and 2013.

Conclusion: Patients with COPD present postural control impairment when compared with age-matched healthy controls. Associated factors contributing to impaired postural control were muscle weakness, physical inactivity, elderly age, need for supplemental oxygen, and limited mobility.

No MeSH data available.


Related in: MedlinePlus