Functional tests associated with balance impairment in chronic obstructive pulmonary disease: Screening implications

Chronic obstructive pulmonary disease (COPD) is a prevalent condition that affects functional capacity and quality of life. Balance impairment remains an underexplored aspect in this population.

To identify factors associated with balance impairment in patients with COPD and to evaluate the utility of balance tests as screening tools in clinical practice.

A cross-sectional study with blinded assessment was conducted, including 132 participants (93 with COPD and 39 healthy controls). The Berg Balance Scale, Timed Up and Go (TUG), and Functional Reach Test were applied, along with assessments of muscle strength, fatigue, and dizziness.

Patients with COPD showed a significantly higher risk of balance impairment (OR 13.0; p<0.0001). The main associated factors were TUG >12s (OR 7.0; p<0.0001), Functional Reach <25cm (OR 14.7; p<0.0001), and history of falls (OR 2.7; p<0.0001). In multivariate analysis, reduced mobility (TUG, p=0.0003), decreased functional reach (p<0.0001), muscle fatigue (Chalder Fatigue Scale, p=0.02), and history of falls (p=0.003) remained significantly associated with balance impairment. The TUG and Functional Reach tests demonstrated good discriminative ability (AUC=0.86 and 0.88, respectively), with sensitivity of 81-85% and specificity of 78-82%.

Balance impairment is frequent in patients with COPD and is associated with reduced mobility, decreased functional reach, fatigue, and history of falls. The TUG and Functional Reach tests showed good utility as screening tools for detecting balance deficits.