Strategies for Fall Risk Assessment and Prevention in People With COPD

Abstract

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease comprising of respiratory-related and systemic effects, including impairments in balance. Balance impairments are especially problematic as they increase the risk of falling, potentially leading to negative outcomes such as hospitalization, disability, and death. The main objectives of this thesis were to 1. determine underlying balance impairments that distinguish between individuals with COPD with and without a history of falls and 2. explore facilitators and barriers of a home-based fall prevention program for people with COPD. The first study of this thesis was a secondary analysis of cross-sectional data that showed that the stability limits/verticality and postural responses subcomponents of the Balance Evaluation Systems Test (BESTest) distinguished between those with and without a fall history among 72 patients with moderate to severe COPD. The stability limits/verticality subcomponent also showed acceptable accuracy in identifying individuals with COPD at high risk of falls (cut-off score of 73.8%). In the second study, a qualitative analysis of interviews with 15 patients who completed a home-based fall prevention program, participants indicated that programs that are personalized and focus on providing support for older adults with COPD may help to improve adherence and reduce participants’ risk of falling. The findings from the two studies included in this thesis provide new knowledge for informing fall risk assessment and prevention for people with COPD.