1. INTRODUCTION
Owing to its systemic effects, several chronic obstructive pulmonary
disease (COPD) are linked with many comorbidities. Although
comorbidities such as cachexia, skeletal muscle weakness, and
osteoporosis are well-known, the balance impairment and falls resultant
from these issues are not adequately emphasized. However, the frequency
of the loss of balance and falls is more among patients with COPD than
in the normal population.1-3 Several factors are known
to contribute to balance impairment in patients with COPD. Of which, the
most remarkable factor is developing muscle atrophies due to decreased
daily life activities. Quadriceps muscle weakness due to immobilization
in patients with COPD is a major risk factor for balance impairment and
fall. Hypoxia, oxidative stress, and systemic inflammation play major
roles in the development of muscle atrophy.4,5Fractures due to impaired balance and falls increase the resultant
morbidity and mortality as a result of decreased quality of life, bed
confinement, increased muscle atrophy, and complications such as
thromboembolism. Therefore, it has been recently emphasized that the
balance impairment should be treated as a part of pulmonary
rehabilitation treatment plan.6
Several tests are available for the evaluation and assessment of balance
impairment and fall risk in patients with COPD. Although the Berg
Balance Scale (BBS) and Balance Evaluation System (BES) tests are the
most recommended tests of all,6 these tests are very
complicated and time consuming as they evaluate numerous factors that
affect the bodily balance of a patient. As a result, it is difficult to
apply these tests to the routine outpatient evaluation of patients with
COPD. Identifying patients at a high risk of balance impairment and fall
with the application of easy-to-use tests at the beginning, followed by
performing more detailed tests later is expected to save the times of
both the patient and the healthcare worker. The initial tests should be
easy to understand and practical. Single Leg Stance (SLS) test, Five
Repetition Sit to Stand Test (5STS), Four Step Square Test (FSST), and
Timed Up and Go (TUG) test are some easy-to-use tests that can
effectively evaluate balance impairment and fall risk.
In this study, we evaluated balance impairment in patients with COPD
using tests that are easier to perform than the BBS test.