Neuromuscular, Balance, and Gait Factors Associated with Falls and Fall-Related Outcomes in Individuals with COPD: A Systematic Review.
Mahsa Zangi, Hasan Shamsi, Amir Rahmani Rasa et al.
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In 30 seconds
This systematic review examined associations between muscle strength, balance, gait and falls or fall-related outcomes in people with COPD. It included 25 original studies involving 1295 participants. Seventeen studies found a significant association with at least one factor; balance impairment was most consistent, with positive associations in 14 of 17 studies. Findings for muscle strength were mixed, while altered gait, particularly greater step-time variability, was also associated with falls. The evidence was predominantly observational, so the review identifies associations rather than establishing that these impairments cause falls.
Key findings
- Seventeen of 25 studies reported a significant association between at least one examined factor and fall history or fall risk.
- Balance impairment was associated with falls or fall-related outcomes in 14 of 17 studies.
- Evidence on muscle strength was mixed; one study linked quadriceps weakness to increased fall risk, reporting an odds ratio of 2.9.
- Altered gait characteristics, particularly increased step-time variability, were associated with falls.
Why it matters
The review suggests that fall-related assessment in COPD should consider balance and gait impairments, not only general deconditioning or muscle weakness. These factors may help frame evaluation of fall risk and rehabilitation research. However, the evidence does not establish causal pathways or show that targeting these impairments reduces falls.
What to keep in mind
The evidence was predominantly observational, limiting causal conclusions. The review also included only English-language studies.