The Relationship Between Pain, Balance and Gait in People With Chronic Obstructive Pulmonary Disease

Study Overview
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Brief Summary
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The balance, gait and pain in Chronic Obstructive Pulmonary Disease (COPD) study will aim to investigate the link between balance and gait impairment, and high rates of pain in people with COPD. This cross-sectional observational study will compare balance and gait outcomes for people with COPD who have pain, to those who are pain free.

Official Title
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An Investigation of the Relationship of Pain With Balance and Gait Impairment in People With Chronic Obstructive Pulmonary Disease

Conditions
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Chronic Obstructive Pulmonary Disease, Balance Impairment, Gait Impairment, Pain

Intervention / Treatment
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* Other: Exposure - pain


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Have a spirometry confirmed diagnosis of COPD as per Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines Be 18 years or over at the point of recruitment Be able to communicate with good verbal English or use adaptive equipment to communicate. Be able to complete test procedures Stable COPD (six weeks clear of exacerbation) No uncorrected visual or somatosensory disturbance Exclusion Criteria: No other conditions that may affect balance or gait e.g. neurological or vestibular conditions Recent exacerbation of COPD (within the last six weeks) Unable to provide written informed consent Unable to speak English or no translation options available Any other acute health conditions that would make activity unsafe e.g. acute infection, unstable cardiac disease.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| COPD with pain<br>People with COPD who also report pain more often than not over the previous 3 months | Other: Exposure - pain<br>* Groups are defined by their naturally occurring exposure to pain or not<br>|
| COPD with no pain<br>People with COPD who do not report pain more often than not over the previous 3 months | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Balance Evaluations Systems Test (BESTest) | BESTest is a quantitative assessment tool that identifies disordered systems underlying postural control that are responsible for poor functional balance. It was developed for clinicians to differentiate balance problems into six underlying systems that may constrain balance. It was developed from the theoretical understanding of balance control systems based on Bernstein's concept that postural control results from a set of interacting systems. It has 36 items that evaluate performance of 6 balance systems: bio-mechanical constraints, stability limits/verticality, anticipatory responses, postural responses, sensory orientation, and stability in gait. A higher score indicates better balance. | 20-30 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Berg Balance Scale | The Berg balance scale is used to objectively determine a patient's ability (or inability) to safely balance during a series of predetermined tasks. It is a 14 item list with each item consisting of a five-point ordinal scale ranging from 0 to 4, with 0 indicating the lowest level of function and 4 the highest level of function. A total score of 56 is available, higher scores indicate better balance. | 5 minutes (for additional items not featured within the BESTest | 
| Gait analysis | Temporospatial gait analysis using the 'Gaitrite' walkway. | 10 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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COPD, balance, gait, pain