Postural balance in COPD with obstructive sleep apnoea: a cross-sectional study

Caroline Maschio de Censo; Viviane Vieira Passini; Bárbara Aparecida Teodoro Alcantara Verri; Rafaella Fagundes Xavier; Regina Maria Carvalho-Pinto; Geraldo Lorenzi-Filho; Celso R F Carvalho

doi:10.1183/23120541.00948-2023

Postural balance in COPD with obstructive sleep apnoea: a cross-sectional study

ERJ Open Res. 2024 Apr 15;10(2):00948-2023. doi: 10.1183/23120541.00948-2023. eCollection 2024 Mar.

Authors

Caroline Maschio de Censo¹, Viviane Vieira Passini², Bárbara Aparecida Teodoro Alcantara Verri¹, Rafaella Fagundes Xavier¹, Regina Maria Carvalho-Pinto², Geraldo Lorenzi-Filho², Celso R F Carvalho¹

Affiliations

¹ Departament of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
² Pulmonary Division, Heart Institute (InCor), Clinics Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.

Abstract

Objective: The aim of this study was to assess the postural balance in COPD patients with obstructive sleep apnoea (OSA). Physical activity, anxiety and depression symptoms, mood, and falls were also assessed in this population.

Methods: Moderate to severe COPD patients were assessed for laboratory and clinical postural balance (force platform and mini-balance evaluation systems test (Mini-BESTest)), physical activity (accelerometry), OSA (polysomnography), sleep quality (Pittsburgh Sleep Quality Index), sleepiness (Epworth Sleepiness Scale), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), dyspnoea (modified Medical Research Council), clinical status (COPD Assessment Test) and mood (Brunel Mood Scale). Self-reported falls were recorded for 6 months via phone calls.

Results: COPD patients (n=70) were divided according to the polysomnography findings into the no OSA (n=30), mild OSA (n=25), and moderate to severe OSA (n=15) groups. Compared to patients with no OSA, those with moderate to severe OSA (msOSA group) presented median (interquartile range) increased path length (30.5 (23.9-34.5) cm versus 39.0 (30.6-52.6) cm, anteroposterior displacement (1.89 (1.39-2.31) cm versus 2.54 (2.06-2.83) cm and postural adjustment velocity (1.02 (0.80-1.15) cm·s^-1 versus 1.30 (1.02-1.76) cm·s^-1) (p<0.05). No differences were observed in the Mini-BESTest scores among the groups. The msOSA group presented a greater number of recurrent fallers in the first follow-up trimester. No association was observed between postural balance and age and pulmonary function.

Conclusion: Individuals with COPD and moderate to severe OSA present changes in postural balance, including broader oscillation, faster postural adjustments and a greater risk of falls than those with no OSA. Physical activity, anxiety and depression symptoms, and mood are similar between COPD patients with and without OSA.