与COPD患者跌倒及跌倒相关结局相关的神经肌肉、平衡和步态因素：一项系统综述。
完整摘要 · 中文译文
背景：慢性阻塞性肺疾病（COPD）患者的跌倒发生率高于年龄匹配的同龄人群，可能导致损伤、丧失独立性和生活质量下降。尽管跌倒常被归因于总体功能退化，但肌力、平衡和步态受损也可能起作用。本系统综述综合了这些因素与COPD患者跌倒或跌倒相关结局之间关系的证据。 方法：检索PubMed、Web of Knowledge、Scopus和Google Scholar中截至2024年11月发表的英文研究。25项涉及1295名参与者的原始研究符合纳入标准。采用改良Downs和Black清单评估方法学质量。 结果：25项研究中有17项报告至少一个所考察因素与跌倒史或跌倒风险之间存在显著关联。平衡受损表现出最一致的关系，17项研究中有14项报告了阳性关联。关于肌力的证据不一致：一些研究将股四头肌无力与跌倒风险增加联系起来，其中一项报告比值比为2.9，而其他研究未发现显著关联。步态特征改变，特别是步时变异性增加，也与跌倒相关。 结论：平衡和步态受损与COPD患者的跌倒及跌倒相关结局一致相关，而与肌力的关系则较不一致。鉴于观察性 需要开展纵向研究、前瞻性研究和对照试验，以阐明因果路径，并确定针对性的平衡与力量训练作为肺康复的一部分是否能够降低跌倒风险。
完整摘要 · 英文原文
BACKGROUND: Individuals with chronic obstructive pulmonary disease (COPD) have a higher incidence of falls than age-matched peers, which may result in injury, loss of independence, and reduced quality of life. Although falls have often been attributed to general deconditioning, impairments in muscle strength, balance, and gait may also contribute. This systematic review synthesized evidence on the relationships between these factors and falls or fall-related outcomes in people with COPD. METHODS: PubMed, Web of Knowledge, Scopus and Google Scholar were searched for English-language studies published up to November 2024. Twenty-five original studies involving 1295 participants met the inclusion criteria. Methodological quality was assessed using a modified Downs and Black checklist. RESULTS: Seventeen of the 25 studies reported a significant association between at least one examined factor and fall history or fall risk. Balance impairment showed the most consistent relationship, with positive associations reported in 14 of 17 studies. Evidence regarding muscle strength was mixed: some studies linked quadriceps weakness to increased fall risk, including one reporting an odds ratio of 2.9, whereas others found no significant association. Altered gait characteristics, particularly increased step-time variability, were also associated with falls. CONCLUSION: Balance and gait impairments are consistently associated with falls and fall-related outcomes in individuals with COPD, whereas the relationship with muscle strength is less consistent. Given the predominance of observational studies, prospective research and controlled trials are needed to clarify causal pathways and determine whether targeted balance and strength training can reduce fall risk as part of pulmonary rehabilitation.