None listed
Conditions
Brief summary
A significant and well-established impact of Chronic Obstructive Pulmonary Disease (COPD) is poor balance and high rates of falling. People with COPD have well identified falls risk factors such as reduced balance, poor strength, and irregular walking patterns. However, further investigation into how balance changes during exertion is required in order to implement strategies for reducing the incidence of accidental falls in this population. The aim of the proposed study is to determine if adults with chronic obstructive pulmonary disease (COPD) have deterioration in their walking pattern (gait) regularity during walking with exertion, and have worse dynamic balance after exertional walking. This study examines changes in balance control (as measured by gait regularity and limits of stability) in adults with COPD during self-paced walking (6 Minute Walk Test) and externally paced walking with regular increases in pace (Shuttle Walking Test). Measures of exertion (Modified Borg Dyspnoea Scale, SPO2 and HR) will be recorded concurrent to each walking task. The study design is repeated measure crossover study in which twenty people with COPD will be recruited from the University Exercise Clinic. Participants with stable COPD will perform both a 6 Minute Walk Test and a Shuttle Walk Test one week apart in a randomised order with gait regularity and oxygen saturation recorded at one minute intervals. Both the walking tasks will be performed on a GAITRite sensor mat recording walking pattern and gait regularity. Before and after each walking task balance (Functional Reach) and perceived level of dyspnoea measures will be taken. Gait regularity will be analysed using linear regression modelling for within task and between task comparisons. If the residuals from linear modelling do not meet the requirements of linear regression then data will be analysed using logistic regression. A paired T test will be used to compare functional reach prior to and after each of the exertional tasks. Covariance accounting for baseline values will be undertaken.
Interventions
Each participant will attend for two testing sessions one week apart (washout). Attendance of total duration two hours (ie one hour each session) with no follow up. At each session one of the two walking tests will be undertaken. Test order will be allocated randomly (computer generated by an independent researcher and numbers provided to research team in opaque envelopes). the two test are;
1. Shuttle Walk Test
A standardised externally paced incremental field walking task that provokes a s
Each participant will attend for two testing sessions one week apart (washout). Attendance of total duration two hours (ie one hour each session) with no follow up. At each session one of the two walking tests will be undertaken. Test order will be allocated randomly (computer generated by an independent researcher and numbers provided to research team in opaque envelopes). the two test are; 1. Shuttle Walk Test A standardised externally paced incremental field walking task that provokes a symptom limited maximal performance Used to assess functional capacity in people with chronic airways obstruction One test is required for learning then a repeat test for assessment The participant is required to walk between two cones in time to a set of auditory beeps played on a CD. Initially, the walking speed is very slow, but each minute the required walking speed progressively increases. The participant walks for as long as they can until they are either too breathless or can no longer keep up with the beeps at which time the test ends. The period of A one-week washout period separates the two tests 2. 6 Minute Walk Test This is a sub maximal test with normative data developed for community dwelling older adults Used as a performance measure of gait endurance Two tests within 30 minutes are required for validity The object of this test is to walk as quickly as possible for six minutes between two markers so that the participant can cover as much ground as possible. The participant may slow down if necessary or stop. The participant may recommence walking again as soon as possible until the full 6 minute duration has elapsed
Sponsors
University of Tasmania
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. People with a confirmed diagnosis of COPD (as determined by a lung function test) 2. Adults (18 years and over) able to provide informed consent to participate in the study 3. A current or recent participant of Pulmonary Rehabilitation at the UTAS, Launceston Campus 4. Able to ambulate independently on a flat even surface to complete the test safely 5. Living at home with or without oxygen supplementation
Exclusion criteria
1. People with end stage COPD that are requiring palliative management 2. People with a self-reported acute infective exacerbation in their symptoms 3. People that require a gait aid, a prosthetic limb, or physical assistance to walk 4. People with a significant neurological condition that affects their gait regularity 5. Women who are pregnant
Outcome results
None listed