Background

The mechanisms underlying impaired balance in chronic obstructive pulmonary disease (COPD) are poorly understood, which makes it difficult to choose the best therapeutic approaches. Therefore, this study aimed to investigate patters of muscular activation to maintain balance and its determinants in this population.

Methods

Thirty-three subjects with COPD and 33 controls were assessed by a force platform in four tasks: standing with eyes opened (FHEO) and closed (FHEC); standing on unstable surface (SUS) and one-legged stance (OLS). Electromyographic activity of lower limb, trunk and neck muscles was concomitantly recorded. To asses functional balance, Brief-balance evaluation systems and timed up & go (TUG) tests were applied. Lung function, exercise capacity and muscle force were also assessed.

Results

Subjects with COPD presented worse balance and higher scalene activation than controls in OLS (mean difference 23.0 [95%CI 1.7–44.3] _%Δ μV_RMS; P = 0.034), besides presenting also higher activation of gluteus medius during FHEC task (mean difference 1.5 [95%CI 0.2–2.8] _%Δ μV_RMS; P = 0.023) and taking longer to complete the TUG (mean difference 0.6 [95%CI 0.1–1.2] seconds; P = 0.042). Exercise capacity and peripheral muscle force were determinants of functional balance (r (Eisner et al., 2011) [2]bib2 = 0.505), whereas age (OR = 1.24; 95%CI 1.02–1.52) and total lung capacity (OR = 2.42; 95%CI 1.05–5.56) were determinants of static balance.

Conclusion

Individuals with COPD have worse static and functional balance in comparison with controls, besides presenting higher activation of scalene and gluteus medius during static balance tasks. Exercise capacity and peripheral muscle force emerged as determinants of functional balance, whereas age and lung hyperinflation contributed to poor static balance.

中文翻译：

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在慢性阻塞性肺疾病患者和控制者之间，为了维持平衡，肌肉激活方面是否存在差异？

背景

慢性阻塞性肺疾病（COPD）中平衡受损的潜在机制了解甚少，这使得难以选择最佳治疗方法。因此，本研究旨在研究肌肉激活的模式，以维持该人群的平衡及其决定因素。

方法

通过力平台评估了33名患有COPD的受试者和33名对照者，完成了以下四个任务：睁开眼睛站立（FHEO）和闭眼站立（FHEC）；站在不稳定的表面（SUS）和单腿姿势（OLS）上。同时记录下肢，躯干和颈部肌肉的肌电活动。为了评估功能平衡，应用了简短平衡评估系统和定时运行（TUG）测试。还评估了肺功能，运动能力和肌肉力量。

结果

COPD患者呈现在OLS比对照更坏平衡和更高的斜角肌活化（平均差异23.0 [95％CI 1.7-44.3] _％ ΔμV _RMS ; P = 0.034），除了FHEC任务期间呈现的臀中肌的也更高的激活（平均差1.5 [95％CI 0.2-2.8] _％ ΔμV _RMS ; P = 0.023）和服用较长时间才能完成的TUG（平均差0.6 [95％CI 0.1-1.2]秒; P = 0.042）。运动能力和外周肌力是功能平衡的决定因素（r（Eisner等，2011）[2] bib2 = 0.505），而年龄（OR = 1.24； 95％CI 1.02-1.52）和总肺活量（OR = 2.42； 95％CI 1.05-5.56）是静态平衡的决定因素。

结论

与COPD个体相比，与静态对照组相比，其静态和功能平衡更差，除了在静态平衡任务中表现出较高的斜角肌和臀中肌活化外。运动能力和周围肌肉力量是功能平衡的决定因素，而年龄和肺过度充气导致静态平衡差。