Functional Capacity and Lower Limb Muscle Strength Impairments Distinguish Fallers from Non-fallers in Older Adults with Chronic Obstructive Pulmonary Diseases Attending National Hospital for Respiratory Diseases and Central Chest Clinic Colombo

Abstract

Background: Older adults with chronic obstructive pulmonary disease (COPD) exhibit reduced lower limb muscle strength and reduced functional capacity compared to their healthy counterparts. There is limited evidence in Sri Lanka on whether functional capacity and lower limb strength can distinguish fallers from non-fallers and identifying these links is important to make targeted rehabilitation and fall prevention interventions. Objective: To identify whether impairments in functional capacity and lower limb muscle strength can distinguish fallers from non-fallers among a selected group of patients with COPD Methods: A cross-sectional study was conducted at Central Chest Clinic Colombo, and National Hospital for Respiratory Diseases Welisara from August to September 2024, involving COPD patients aged 60 and older according to the consecutive sampling technique. Lower limb muscle strength was assessed using the Five times Sit-To-Stand test (5STS), while functional capacity was evaluated with a Six-Minute Walk Test (6MWT). Results: A total of 229 individuals with COPD (177 males) with a mean±SD age of 70±6.8 years were recruited. Of them, 24.9% reported at least one fall in the previous 12 months and 69.9% were ex-smokers. Mean±SD 5STS and 6MWD scores were 20.8±6.4 seconds and 353.9±92.2 meters, respectively. Females took significantly longer time to complete 5STS test (21.6±5.6 seconds) compared to males (20.6±5.6 seconds) (p=0.001), whereas males demonstrated a higher mean±SD 6MWD (369.8±96.7 meters) than females (343.8±72.3 meters) (p=0.004). Fallers (24.8±7.6 seconds) required significantly more time to complete the 5STS test than non-fallers (19.5±5.4 seconds) (p=0.001), whereas non-fallers (388.0±85.0 meters) covered a significantly longer distance during the 6-minute walk test compared to fallers (291.0±73.2 meters) (p=0.001). Conclusions: In the selected group of patients with COPD, there were significant impairments identified in muscle strength and functional capacity among fallers compared to non-fallers.