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Impaired Balance and Gait Characteristics in Patients With Chronic Heart Failure
Emine Burcu Ozcan1, Melda Saglam1, Naciye Vardar-Yagli1
1Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
Insights
Patients with chronic heart failure (CHF) exhibit poorer balance and gait compared to healthy individuals. Cardiac rehabilitation programs should incorporate balance and walking training to mitigate these deficits and reduce fall risk in CHF patients.
Area of Science:
- Cardiology
- Neurology
- Physical Therapy
Background:
- Heart failure (HF) significantly impacts multiple bodily systems, leading to balance deficits and gait deviations.
- Limited research exists on specific balance and gait parameters in patients with chronic heart failure (CHF).
Purpose of the Study:
- To investigate balance abnormalities and gait deficits in patients with CHF.
- To explore potential associations between balance and gait impairments in CHF.
- To compare balance and gait parameters in CHF patients against healthy controls.
Main Methods:
- A cross-sectional study comparing 22 CHF patients with 22 age- and gender-matched healthy controls.
- Balance assessed using the Activity-Specific Balance Confidence Scale (ABC) and Mini-Balance Evaluation Systems Test (Mini-BESTest).
- Gait analysis via Biodex Gait Trainer; muscle strength and exercise capacity measured using handgrip, quadriceps strength, and the six-minute walk test (6MWT).
Main Results:
- CHF patients demonstrated significantly lower balance confidence (ABC score) and overall balance performance (Mini-BESTest).
- Impaired gait parameters in CHF included reduced gait speed, stride length, and step length.
- CHF patients exhibited significantly reduced peripheral muscle strength and exercise capacity (6MWT distance).
Conclusions:
- Patients with CHF experience significant impairments in balance, gait, muscle strength, and exercise capacity.
- Cardiac rehabilitation programs for CHF should integrate balance and walking training to address these deficits.
- Targeted interventions can help prevent falls and improve functional outcomes in individuals with CHF.
Background And Aims:
Heart failure affects most systems of the body and causes various problems in patients. Balance deficits and gait deviations can be a result of these effects. There is little information in the literature about balance and gait parameters in chronic heart failure (CHF). This study aimed to investigate balance abnormalities together with gait deficits for possible associations in patients with CHF and compare them to healthy controls.
Methods:
Twenty-two (22) patients with CHF (59±2.5 years) and 22 age- and gender-matched healthy subjects (59.4±6.8 years) participated in the study. This study is a cross-sectional/comparison study. Balance was evaluated using the Activity-Specific Balance Confidence Scale (ABC) and the Mini-Balance Evaluation Systems Test (Mini-BESTest) balance battery, which includes the timed up-and-go test (TUG) and dual-task TUG. Gait analysis was performed using a Biodex Gait Trainer. Peripheral muscle strength (quadriceps muscle and handgrip strength) was assessed using a hand dynamometer and exercise capacity using the six-minute walk test (6MWT).
Results:
The CHF patients had significantly lower Mini-BESTest total, reactive postural control, and gait stability scores, significantly longer TUG/dual-task TUG time, and lower ABC score compared to the healthy control group (p<0.05). Chronic heart failure patients also showed significantly lower gait speed, stride length, gait cycle and step length (p<0.05). Dominant-side quadriceps muscle and handgrip strength and 6MWT distance were significantly reduced in CHF (p<0.05). Anticipatory postural adjustments and sensory orientation did not differ between groups.
Conclusions:
Our study demonstrated impaired balance and gait performance and reduced muscle strength and exercise capacity in patients with CHF. Cardiac rehabilitation including balance and walking training should be planned for CHF patients to eliminate balance disorders, gait impairment and prevent falls in this patient group.
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