Falls and balance in patients with COPD

People with COPD fall more than healthy adults of the same age, and approximately half of all individuals who suffer an acute exacerbation will experience a fall. Balance is a major risk factor for falls, and while the exact mechanisms underpinning poor balance in people with COPD are unknown, reduced muscle strength, poor neuromuscular coordination of core muscles and musculoskeletal pain may play a role. Guidelines recommend assessing balance in PR. HCPs should enquire whether individuals aged ≥65 years have fallen in the past year, while being mindful of the fall-related stigma that is common in older adults. Screening for balance impairment can be performed quickly using the timed up and go test, a standing balance test or a repeated chair–stand test. If indicated, the Berg Balance Scale or the mini-Balance Evaluation Systems Test offers a comprehensive balance assessment and informs targeted balance training, which has been delivered successfully alongside PR.