A TUG Value Longer Than 11 s Predicts Fall Risk at 6-Month in Individuals with COPD

Vivien Reynaud, Daniela Muti, Bruno Pereira, Annick Greil, Denis Caillaud, Ruddy Richard, Emmanuel Coudeyre, Frédéric Costes, Vivien Reynaud, Daniela Muti, Bruno Pereira, Annick Greil, Denis Caillaud, Ruddy Richard, Emmanuel Coudeyre, Frédéric Costes

Abstract

Risk of a fall is increased in individuals with chronic obstructive pulmonary disease (COPD), and is usually evaluated using the Berg Balance Scale (BBS), but this is difficult to perform in everyday clinical practice. We aimed to prospectively predict short-term fall recurrence in COPD patients using a predetermined cut-off value of the Timed Up and Go test (TUG). In stable COPD patients, we collected self-reported records of the number of falls in the previous year, and measured TUG and BBS scores for each individual. Records of fall recurrence were obtained prospectively at 6-months after the initial evaluation. Among the 50 patients recruited, 23 (46%) had at least one fall during the past year. The optimal diagnosis value for the TUG to detect a fall was 10.9 s with a sensitivity of 100% and a specificity of 97%. A cut-off of 11 s predicted fall recurrence with high sensitivity and specificity (93% and 74%, respectively). The TUG as well as the BBS score detected fallers, and a cut-off value of 11 s predicted fall recurrence. TUG could be easily incorporated into the scheduled functional evaluations of COPD patients, could predict the risk of a fall and when appropriate, could guide specific balance training exercises to prevent fall.

Keywords: Chronic obstructive pulmonary disease; Fall; Hypoxia; Postural balance; Risk factor; Timed Up and Go test.

Conflict of interest statement

Each individual named as an author meets the uniform Requirements for Manuscripts Submitted to biomedical Journals criteria for authorship. The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Receiver operating characteristic (ROC) curves for detecting fallers with the Berg Balance Scale score (BBS, black) and with the Timed Up and Go test (TUG, red). Area under curves (AUC) is indicated at the bottom of the paragraph.
Figure 2
Figure 2
Forest plot of the multivariable analysis of determinants of past falls. The analysis was adjusted for gender, age, and BMI, all of which were non-significant determinants, and which were therefore omitted from the graph for clarity. LTOT, treatment with long-term oxygen therapy; FFM, fat-free mass (kg); 6MWD%pred, 6-min walking distance expressed as a percentage of the predicted value; qPT 60°, isokinetic quadriceps peak torque (PT) at concentric 60°.

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Source: PubMed

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