Determinants of Balance in Patients With Chronic Obstructive Pulmonary Disease

Study Overview
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Brief Summary
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The primary aim of our study is to examine the relationship between balance and respiratory function, respiratory and peripheral muscle strength, functional capacity, and cognitive function in patients with Chronic Obstructive Pulmonary Disease (COPD). The secondary aim of our study is to compare respiratory function, respiratory and peripheral muscle strength, functional capacity, balance, and cognitive functions of COPD patients and healthy individuals. This study will examine and record the participant's sociodemographic information and medical records. Balance, respiratory function, respiratory and peripheral muscle strength, functional capacity, and cognitive function will be assessed. Since the patients are included in this study, no intervention will be made, no additional tests will be performed, or no changes will be made in the routine treatments of the patients during the study.

Official Title
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Determinants of Balance in Patients With Chronic Obstructive Pulmonary Disease

Conditions
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Chronic Obstructive Pulmonary Disease

Intervention / Treatment
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* Other: Balance Assessment
* Other: Pulmonary function test
* Other: Respiratory muscle strength test
* Other: Peripheral muscle strength test
* Other: 6-minute walk test
* Other: Cognitive assessment


Participation Criteria
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Eligibility Criteria
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COPD Group Inclusion Criteria: Being diagnosed with COPD in accordance with the GOLD criteria Being between the ages of 40-65 To be able to speak, read, understand, and cooperate in Turkish Being a volunteer to participate in the study COPD Group Exclusion Criteria: Having a COPD exacerbation in the last 8 weeks and/or having an unstable clinical condition Having a diagnosed vision, hearing, or neurological disease that may affect balance Having any other neurological, orthopedic, cardiovascular, thoracic, or metabolic disease or pathological condition that would affect assessments Resting saturation below 90% during exercise tests Being on long-term oxygen therapy Control Group Inclusion Criteria: Being between the ages of 40-65 To be able to speak, read, understand, and cooperate in Turkish Being a volunteer to participate in the study Control Group Exclusion Criteria: Having a diagnosed vision, hearing, or neurological disease that may affect balance Having any other neurological, orthopedic, cardiovascular, thoracic, or metabolic disease or pathological condition that would affect assessments Resting saturation below 90% during exercise tests

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| COPD Group<br>Balance assessment, Pulmonary function test, Respiratory muscle strength test, Peripheral muscle strength test, 6-minute walk test, Cognitive assessment | Other: Balance Assessment<br>* Balance assessment will be done with the Biodex Balance System® (Biodex Medical Systems, Shirley, New York, United States). Postural stability test overall score, stability limits test overall score, and sensory integration test of balance composite score will be recorded.<br>Other: Pulmonary function test<br>* Pulmonary function test will be performed with a spirometer (COSMED Pony FX (COSMED; Italy) in accordance with ATS/ERS criteria. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, peak expiratory volume measured at 25% and 75% of forced expiratory time (FEF 25-75%), and peak expiratory volume (PEF) parameters will be measured. The results will be recorded both as a percentage of measured values and expected values.<br>Other: Respiratory muscle strength test<br>* Respiratory muscle strength will be measured in accordance with ATS/ERS criteria using an electronic, mobile, (MicroRPM, Micro Medical; UK) intraoral pressure measuring device. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) values will be recorded. Three measurements will be repeated for each maneuver and the highest value recorded as cmH2O.<br>Other: Peripheral muscle strength test<br>* Peripheral muscle strength will be assessed by measuring M. Quadriceps muscle strength with a digital handheld dynamometer (MicroFET® Hoggan Scientific; USA). The test will be done in three measurements for the dominant side lower extremity. The average of the obtained values will be recorded in kilograms.<br>Other: 6-minute walk test<br>* Functional capacity will be assessed with the 6-minute walk test (6MWT). 6MWT will be performed in accordance with the criteria of the American Thoracic Society. The 6MWT distance will be recorded in meters.<br>Other: Cognitive assessment<br>* Cognitive function will be assessed with the Montreal Cognitive Assessment (MoCA) test. The MoCA test is a questionnaire developed to evaluate different cognitive functions and mild cognitive impairment. The maximum score that an individual can obtain from the test is 30, and a score of 21 or above is considered as mild cognitive impairment. Test; will be administered by a certified physiotherapist who has received training on practice and scoring directives<br>|
| Control Group<br>Balance assessment, Pulmonary function test, Respiratory muscle strength test, Peripheral muscle strength test, 6-minute walk test, Cognitive assessment | Other: Balance Assessment<br>* Balance assessment will be done with the Biodex Balance System® (Biodex Medical Systems, Shirley, New York, United States). Postural stability test overall score, stability limits test overall score, and sensory integration test of balance composite score will be recorded.<br>Other: Pulmonary function test<br>* Pulmonary function test will be performed with a spirometer (COSMED Pony FX (COSMED; Italy) in accordance with ATS/ERS criteria. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, peak expiratory volume measured at 25% and 75% of forced expiratory time (FEF 25-75%), and peak expiratory volume (PEF) parameters will be measured. The results will be recorded both as a percentage of measured values and expected values.<br>Other: Respiratory muscle strength test<br>* Respiratory muscle strength will be measured in accordance with ATS/ERS criteria using an electronic, mobile, (MicroRPM, Micro Medical; UK) intraoral pressure measuring device. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) values will be recorded. Three measurements will be repeated for each maneuver and the highest value recorded as cmH2O.<br>Other: Peripheral muscle strength test<br>* Peripheral muscle strength will be assessed by measuring M. Quadriceps muscle strength with a digital handheld dynamometer (MicroFET® Hoggan Scientific; USA). The test will be done in three measurements for the dominant side lower extremity. The average of the obtained values will be recorded in kilograms.<br>Other: 6-minute walk test<br>* Functional capacity will be assessed with the 6-minute walk test (6MWT). 6MWT will be performed in accordance with the criteria of the American Thoracic Society. The 6MWT distance will be recorded in meters.<br>Other: Cognitive assessment<br>* Cognitive function will be assessed with the Montreal Cognitive Assessment (MoCA) test. The MoCA test is a questionnaire developed to evaluate different cognitive functions and mild cognitive impairment. The maximum score that an individual can obtain from the test is 30, and a score of 21 or above is considered as mild cognitive impairment. Test; will be administered by a certified physiotherapist who has received training on practice and scoring directives<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postural stability test: Overall score |  | 15-20 minutes | 
| Stability limits test: Overall score |  | 15-20 minutes | 
| Sensory integration test of balance: Composite score |  | 20-30 minutes | 
| Forced vital capacity (FVC) |  | 10-15 minutes | 
| Forced expiratory volume in 1 second (FEV1) |  | 10-15 minutes | 
| FEV1/FVC |  | 10-15 minutes | 
| Forced expiratory flow 25-75% (FEF25-75) |  | 10-15 minutes | 
| Peak expiratory flow (PEF) |  | 10-15 minutes | 
| Maximal inspiratory pressure (MIP) |  | 15-20 minutes | 
| Maximal expiratory pressure (MEP) |  | 15-20 minutes | 
| Quadriceps muscle strength |  | 15-20 minutes | 
| 6-minute walk test |  | 15-20 minutes | 
| MoCA test |  | 10-15 minutes |