Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review

Matteo Zago, Chiarella Sforza, Daniela Rita Bonardi, Enrico Eugenio Guffanti, Manuela Galli

Research output: Contribution to journalReview article

Abstract

BACKGROUND: Gait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD.

RESEARCH QUESTION: Thus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD.

METHODS: In line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool.

RESULTS: Seven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level.

SIGNIFICANCE: A convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD.

Original languageEnglish
Pages (from-to)408-415
Number of pages8
JournalGait and Posture
Volume61
DOIs
Publication statusPublished - Mar 2018

Fingerprint

Gait
Chronic Obstructive Pulmonary Disease
Sample Size
Accidental Falls
Cross-Sectional Studies
Biomechanical Phenomena
PubMed
Ankle
Uncertainty
Longitudinal Studies
Databases
Guidelines
Phenotype
Research

Keywords

  • Accidental Falls/statistics & numerical data
  • Aged
  • Biomechanical Phenomena/physiology
  • Female
  • Gait/physiology
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive/physiopathology
  • Risk Factors
  • Spatio-Temporal Analysis

Cite this

Gait analysis in patients with chronic obstructive pulmonary disease : a systematic review. / Zago, Matteo; Sforza, Chiarella; Bonardi, Daniela Rita; Guffanti, Enrico Eugenio; Galli, Manuela.

In: Gait and Posture, Vol. 61, 03.2018, p. 408-415.

Research output: Contribution to journalReview article

Zago, Matteo ; Sforza, Chiarella ; Bonardi, Daniela Rita ; Guffanti, Enrico Eugenio ; Galli, Manuela. / Gait analysis in patients with chronic obstructive pulmonary disease : a systematic review. In: Gait and Posture. 2018 ; Vol. 61. pp. 408-415.
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abstract = "BACKGROUND: Gait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD.RESEARCH QUESTION: Thus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD.METHODS: In line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool.RESULTS: Seven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level.SIGNIFICANCE: A convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD.",
keywords = "Accidental Falls/statistics & numerical data, Aged, Biomechanical Phenomena/physiology, Female, Gait/physiology, Humans, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive/physiopathology, Risk Factors, Spatio-Temporal Analysis",
author = "Matteo Zago and Chiarella Sforza and Bonardi, {Daniela Rita} and Guffanti, {Enrico Eugenio} and Manuela Galli",
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TY - JOUR

T1 - Gait analysis in patients with chronic obstructive pulmonary disease

T2 - a systematic review

AU - Zago, Matteo

AU - Sforza, Chiarella

AU - Bonardi, Daniela Rita

AU - Guffanti, Enrico Eugenio

AU - Galli, Manuela

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2018/3

Y1 - 2018/3

N2 - BACKGROUND: Gait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD.RESEARCH QUESTION: Thus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD.METHODS: In line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool.RESULTS: Seven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level.SIGNIFICANCE: A convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD.

AB - BACKGROUND: Gait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD.RESEARCH QUESTION: Thus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD.METHODS: In line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool.RESULTS: Seven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level.SIGNIFICANCE: A convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD.

KW - Accidental Falls/statistics & numerical data

KW - Aged

KW - Biomechanical Phenomena/physiology

KW - Female

KW - Gait/physiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Pulmonary Disease, Chronic Obstructive/physiopathology

KW - Risk Factors

KW - Spatio-Temporal Analysis

U2 - 10.1016/j.gaitpost.2018.02.007

DO - 10.1016/j.gaitpost.2018.02.007

M3 - Review article

C2 - 29462775

VL - 61

SP - 408

EP - 415

JO - Gait and Posture

JF - Gait and Posture

SN - 0966-6362

ER -