PDF(Pubmed)
Abstract：
BACKGROUND: Despite the importance of gait as a determinant of falls, disability and mortality in older people, understanding of gait impairment in COPD is limited. This study aimed to identify differences in gait characteristics during supervised walking tests between people with COPD and healthy controls.
METHODS: We searched 11 electronic databases, supplemented by Google Scholar searches and manual collation of references, in November 2019 and updated the search in July 2021. Record screening and information extraction were performed independently by one reviewer and checked for accuracy by a second. Meta-analyses were performed in studies not considered at a high risk of bias.
RESULTS: Searches yielded 21 085 unique records, of which 25 were included in the systematic review (including 1015 people with COPD and 2229 healthy controls). Gait speed was assessed in 17 studies (usual speed: 12; fast speed: three; both speeds: two), step length in nine, step duration in seven, cadence in six, and step width in five. Five studies were considered at a high risk of bias. Low-quality evidence indicated that people with COPD walk more slowly than healthy controls at their usual speed (mean difference (MD) -19 cm·s-1, 95% CI -28 to -11 cm·s-1) and at a fast speed (MD -30 cm·s-1, 95% CI -47 to -13 cm·s-1). Alterations in other gait characteristics were not statistically significant.
CONCLUSIONS: Low-quality evidence shows that people with COPD walk more slowly than healthy controls, which could contribute to an increased falls risk. The evidence for alterations in spatial and temporal components of gait was inconclusive. Gait impairment appears to be an important but understudied area in COPD.
METHODS: We searched 11 electronic databases, supplemented by Google Scholar searches and manual collation of references, in November 2019 and updated the search in July 2021. Record screening and information extraction were performed independently by one reviewer and checked for accuracy by a second. Meta-analyses were performed in studies not considered at a high risk of bias.
RESULTS: Searches yielded 21 085 unique records, of which 25 were included in the systematic review (including 1015 people with COPD and 2229 healthy controls). Gait speed was assessed in 17 studies (usual speed: 12; fast speed: three; both speeds: two), step length in nine, step duration in seven, cadence in six, and step width in five. Five studies were considered at a high risk of bias. Low-quality evidence indicated that people with COPD walk more slowly than healthy controls at their usual speed (mean difference (MD) -19 cm·s-1, 95% CI -28 to -11 cm·s-1) and at a fast speed (MD -30 cm·s-1, 95% CI -47 to -13 cm·s-1). Alterations in other gait characteristics were not statistically significant.
CONCLUSIONS: Low-quality evidence shows that people with COPD walk more slowly than healthy controls, which could contribute to an increased falls risk. The evidence for alterations in spatial and temporal components of gait was inconclusive. Gait impairment appears to be an important but understudied area in COPD.
摘要：
背景：尽管步态作为跌倒的决定因素很重要，老年人的残疾和死亡率，对COPD患者步态损害的认识有限.这项研究旨在确定COPD患者和健康对照者在监督步行测试中步态特征的差异。
方法：我们搜索了11个电子数据库，辅以谷歌学者搜索和人工整理参考文献，2019年11月，并于2021年7月更新了搜索。记录筛选和信息提取由一名审阅者独立进行，并在一秒钟内检查准确性。荟萃分析是在未被认为存在高偏倚风险的研究中进行的。
结果：搜索产生了21085条独特记录，其中25例纳入系统评价(包括1015例COPD患者和2229例健康对照).在17项研究中评估了步态速度（通常速度：12；快速速度：3；两种速度：2），步长为九，第七步的持续时间，六分钟的节奏，和5步的宽度。五项研究被认为存在高偏倚风险。低质量证据表明，COPD患者在正常速度（平均差（MD）-19cm·s-1，95％CI-28至-11cm·s-1）和较快速度（MD-30cm·s-1，95％CI-47至-13cm·s-1）下比健康对照组步行更慢。其他步态特征的改变没有统计学意义。
结论：低质量证据表明，COPD患者的步行速度比健康对照组慢，这可能导致跌倒风险增加。步态时空成分改变的证据尚无定论。步态障碍似乎是COPD中一个重要但研究不足的领域。
方法：我们搜索了11个电子数据库，辅以谷歌学者搜索和人工整理参考文献，2019年11月，并于2021年7月更新了搜索。记录筛选和信息提取由一名审阅者独立进行，并在一秒钟内检查准确性。荟萃分析是在未被认为存在高偏倚风险的研究中进行的。
结果：搜索产生了21085条独特记录，其中25例纳入系统评价(包括1015例COPD患者和2229例健康对照).在17项研究中评估了步态速度（通常速度：12；快速速度：3；两种速度：2），步长为九，第七步的持续时间，六分钟的节奏，和5步的宽度。五项研究被认为存在高偏倚风险。低质量证据表明，COPD患者在正常速度（平均差（MD）-19cm·s-1，95％CI-28至-11cm·s-1）和较快速度（MD-30cm·s-1，95％CI-47至-13cm·s-1）下比健康对照组步行更慢。其他步态特征的改变没有统计学意义。
结论：低质量证据表明，COPD患者的步行速度比健康对照组慢，这可能导致跌倒风险增加。步态时空成分改变的证据尚无定论。步态障碍似乎是COPD中一个重要但研究不足的领域。
