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J. Clin. Med. 2019, 8(4), 459; https://doi.org/10.3390/jcm8040459

Effects of Pulmonary Rehabilitation on Gait Characteristics in Patients with COPD

1
Department of Research and Education, CIRO, 6085 NM Horn, The Netherlands
2
Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, P.O. Box 616, 6200 MD Maastricht, The Netherlands
3
Department of Respiratory Medicine, Maastricht University Medical Centre+, 6229 HX Maastricht, The Netherlands
4
Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, 6229 ER Maastricht, The Netherlands
*
Author to whom correspondence should be addressed.
Received: 17 March 2019 / Revised: 27 March 2019 / Accepted: 3 April 2019 / Published: 5 April 2019
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Abstract

Pulmonary rehabilitation (PR) improves lower-limb muscle function in patients with chronic obstructive pulmonary disease (COPD). However, it remains unclear whether patients improve gait characteristics, in particular stride-to-stride fluctuations that are associated with fall risks. This study aims to identify whether, and to what extent, PR affects positively gait characteristics in COPD. In this prospective observational study, 44 COPD patients (aged: 62 ± 7 years; Forced expiratory volume in 1 s 56 ± 20% predicted) performed self-paced, treadmill 6-min-walk tests (Gait Real-time Analysis Interactive Lab) before and after PR, while spatiotemporal parameters and center of mass position were recorded (100 Hz, Vicon Nexus). Standard deviation, coefficient of variation, predictability (sample entropy), and consistency in organization (local divergence exponent) were calculated. Sub-analysis was performed to identify gait differences between good and poor responders (<30 m change in a 6-min-walk distance). Patients demonstrated shorter stride times (p = 0.001) and improved lower-limb muscle function (p < 0.001) following PR. The good responders had a greater increase in stride length (p < 0.001) and a greater decrease in stride time (p < 0.001) compared to the poor responders. Current PR improved stride time in patients, while movement patterns within stride-to-stride fluctuations did not change. Training programs specifically targeting balance issues and gait function may be beneficial in improving gait characteristics in COPD. View Full-Text
Keywords: gait variability; locomotion; lung disease; entropy; Lyapunov exponent; 3D motion analysis gait variability; locomotion; lung disease; entropy; Lyapunov exponent; 3D motion analysis
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MDPI and ACS Style

Liu, W.-Y.; Meijer, K.; Delbressine, J.M.; Willems, P.J.; Wouters, E.F.M.; Spruit, M.A. Effects of Pulmonary Rehabilitation on Gait Characteristics in Patients with COPD. J. Clin. Med. 2019, 8, 459.

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