DOI: https://doi.org/10.53350/pjmhs22161659 ORIGINAL ARTICLE P J M H S Vol. 16, No.01, JAN 2022 659 Comparison of Balance Impairment among Chronic Obstructive Pulmonary Disease (COPD) and Healthy Population TAHZEEM RIAZ 1 , QURAT UL AIN 2 , MAHA AMJAD 3 , AYESHA FIAZ 4 , YASHA SAJJAD 5 , SADAF WARIS 6 1 Clinical Physiotherapist Riphah Rehabilitation Clinic, Lahore, Pakistan 2 Senior Lecturer qurat.ain@riphah.edu.pk 3 House Officer Riphah International University, Lahore 4,5 Clinical Physiotherapist Riphah Rehabilitation Clinic, Lahore, Pakistan 6 Senior Lecturer Avicenna Medical and Dental College Corresponding author: Sadaf Waris, Email: dr.sadaf54@gmail.com, Cell: 0308-8112501 ABSTRACT Background: Chronic obstructive pulmonary disease (COPD) is a condition that affects respiratory system. Balance impairments are increasingly seen in patients suffering from COPD resulting in the onset of risk of falls. Objective: To compare balance impairment and fall risk between COPD patients and healthy individuals. Methodology: A comparative cross-sectional study was conducted on 16 clinically stable COPD patients and 16 healthy individuals, with age range of 40-65 years. Berg balance scale (BBS), activity Specific balance confidence scale (ABC) and Time Up and Go test (TUG) were administered to evaluate balance impairments. Results: Independent sample T-test was applied to compare the difference in tests in both groups. Statistically significant difference was observed between two groups in terms of their BBS, ABC and TUG all with p<0.05. Pearson correlation test was used to check the correlation of age, BMI, and smoking with balance. Conclusion: The study concluded that COPD patients have balance impairments and high risks of falls as compared to healthy individuals. Furthermore, the study shows positive correlation of BMI and no relation of age and smoking with balance impairment. Keywords: Balance Impairments, Berg balance scale, Chronic obstructive pulmonary disease, Fall, Time up and go test. INTRODUCTION Chronic obstructive pulmonary disease (COPD) is a condition that affects respiratory system and is progressive in nature and has characteristic of airflow obstruction and respiratory distress. COPD is a major health problem globally as it is the fourth leading cause of death in developed countries and estimated to become the third leading cause in 2030. (1) COPD imposes a colossal pressure on people suffering from this disease, which can include a variety of symptoms. Commonly present symptoms for this condition are shortness of breath, production of sputum and cough. On the other hand less commonly present symptoms are congestion, wheezing and chest tightness. Moreover, COPD effect physical and psychological health of a person. (2) Exercise tolerance, peripheral muscle performance and functional mobility get reduced in COPD but recent studies have demonstrated that such people have a noticeable loss in balance control. (3) Falls in the elderly have bad impacts on social life, functional independence and life expectancy. A recent research demonstrates that COPD has second highest risk of falls after the osteoarthritis in case of chronic pathologies. (4) Incidence rate of fall is 25 to 46% in COPD. (5) A complex interaction exists between motor and sensory input that explains for the underlying mechanisms for balance disorders in COPD. Whenever there is a postural challenge and balance is disturbed the trunk and respiratory musculature specifically diaphragm play a vital role in stabilizing the body. It is reasonable to suggest that surge in working of respiratory muscles in people with COPD might jeopardize their role in stabilizing postures. Much of the literature has clearly stated that balance difficulties are related with muscular weakness in cases of stable COPD. (6) More severity of this disease causes patients to lose muscular girth, targeting thighs mainly. Consequently, patients have reduced levels of endurance, spiked levels of fatigue, and dyspnea even at minimum work. All these symptoms lead to decreased ability to perform daily life work activities and decrease patient tolerance towards exercise causing generalized decrease in mobility. Lower limbs muscular weakness is a non- pulmonary risk factor for falls in spite of this COPD have greater risk of falls than normal people. (7) Poor postural control is common in elder population. It is known that 30% of individuals greater than 60 years of age fall at least once per year, and that the fall incidence spikes up to 45% when people reach age of more than 70 years. Faulty postural control is more common whenever there is any chronic underlying condition in elders. The PLATINO study showed that COPD is more prevalent in old population. (4) Lower limb musculature weakness, labyrinthine disorders, functional dependence and the lack of ability of realigning the body if balance is disturbed are all risk factors for fall and are well established in previous studies. Additionally, the consequences of falls are costly for the health care system. (1) Falls are not only linked with increased chances of morbidity and increased chances of mortality but are also related to poor daily functioning and early onset admissions to hospitals, furthermore reduction in falls is pivotal health system goal. Proper assessment for the causes of faulty posture is very important in order to prevent hazards of falls. It is important to identify risks of falls in COPD populations as they also have high rates of osteoporosis that can lead to fractures on falling and it can complicate the situation further by prolonged hospitalizations. (8) In