ORIGINAL ARTICLE   

Panminerva Medica 2024 March;66(1):10-7

DOI: 10.23736/S0031-0808.23.04892-9

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Pulmonary rehabilitation and risk of fall in elderly with chronic obstructive pulmonary disease

Matteo TARASCONI ¹, Federico M. OLIVA ¹, Nicolino AMBROSINO ², Giovanni SOTGIU ³, Laura SADERI ³, Elisabetta ZAMPOGNA ¹ ✉, Ombretta MENTASTI ¹, Antonio SPANEVELLO ^{1, 4}, Dina VISCA ^{1, 4}

¹ Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Varese, Italy; ² Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Montescano, Pavia, Italy; ³ Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Medicine, University of Sassari, Sassari, Italy; ⁴ Department of Medicine and Surgery, University of Insubria, Varese, Italy

BACKGROUND: Few data are available on the effects of pulmonary rehabilitation (PR) on risk of fall in over 80 individuals with chronic obstructive pulmonary disease (COPD). We investigated the effectiveness of PR on the risk of fall in older as compared to younger than 80 individuals.
METHODS: Parallel-group retrospective exploratory study of individuals undergone in-hospital PR. The risk of fall was defined as a gait speed ≤0.8 m/s (primary outcome). Outcome measures (exercise capacity, physical performance, symptoms, and health status) were also assessed.
RESULTS: As compared to younger, individuals over 80 suffered from more severe symptoms, a reduction in physical performance and in exercise capacity and greater risk of fall (P=0.0001). The proportion of participants at risk of fall increased with age, and after PR decreased significantly without any significant difference between age groups. However, 53.4% of older individuals were still at risk of fall, as compared to 17.5% of those under 80 (P=0.0001). After PR, both populations had improved outcomes measures, without any significant between group differences.
CONCLUSIONS: In individuals with COPD pulmonary rehabilitation reduced the risk of fall, while improving outcome measures independent of age, however, more than 50% of those over 80 were still at risk of fall. The pulmonary rehabilitation programs for individuals over 80 should include strategies effective in reducing the risk of fall.

KEY WORDS: Exercise; Rehabilitation; Aged; Postural balance; Gait