Postural assessment in stable COPD patients and its correlation with disease severity

Patients with chronic obstructive pulmonary disease (COPD) often experience dyspnea, which can lead to postural adaptations. Some studies suggest that these postural alterations may affect balance and gait. However, little is known about the association between postural changes-particularly those involving the shoulder girdle-and COPD severity.

To investigate the relationship between shoulder girdle postural alterations in COPD patients and functionality (assessed by the 6-min walk test [6MWT] and functional reach test [FRT]), dyspnea (measured by the modified Medical Research Council [mMRC] scale), and disease severity (assessed by forced expiratory volume in 1 s [FEV₁]).

Stable COPD patients underwent postural assessment using the Software for Postural Evaluation (SAPO), spirometry, dyspnea evaluation via the mMRC scale, the FRT, and the 6MWT.

A positive correlation was observed between the head protraction angle-measured from the right and left lateral views-and the distance reached in the FRT (r = 0.64 and r = 0.66, respectively; p < 0.0001). No significant relationship was found between FEV₁ and postural changes. Patients reporting dyspnea showed a significantly shorter FRT range (34.67 cm vs. 37.91 cm; p = 0.0061) compared to those without dyspnea. Additionally, a statistically significant correlation was observed between the horizontal head angle and the distance achieved in the 6MWT (r = 0.39, r² = 0.15; p = 0.004).

Although no correlation was found between postural changes and spirometric parameters (FEV₁ and FVC), there was a significant association with functional performance in the FRT and 6MWT. These findings suggest that postural assessment may be a valuable tool for planning and monitoring pulmonary rehabilitation in COPD patients.