Application Of Balance Function Test Scales In Elderly Patients With Chronic Obstructive Pulmonary Disease

BackgroundPatients with chronic obstructive pulmonary disease(COPD)have different degrees of balance function decline,which not only increases the risk of falls,but also reduces the quality of life,resulting in a serious disease burden.The balance function test method can be used to screen the fall risk of patients with COPD,which is conducive to early clinical intervention and reduce the occurrence of falls.However,at present,there is no unified standard for balance function testing methods in COPD patients,and there are rarely related researches in China.It is urgent to find out the most appropriate screening tool to provide certain reference basis for clinical selection.Objective1.To find scales suitable for the balance function test in elderly patients with COPD.2.A comparative study of different balance function test scales was conducted to find out the most appropriate screening tool to provide certain reference basis for clinical selection.Methods1.Using the Evidence-based methodology,to systematically search,screen and evaluate relevant domestic and foreign literature to summarize the best evidence of balance function test in elderly patients with COPD and provide reference for clinical practice research.2.From May 2020 to May 2021,some COPD patients admitted to the respiratory medicine specialist outpatient department of a tertiary hospital in Guangdong were selected by convenience sampling method.According to whether they had a fall history within 6 months before,they were divided into two groups.Their balance abilities were assessed using the different balance function test scales.Taking 6-month history of falls as the diagnostic standard,the identification ability of the different scales for falls was compared by Bayes discriminant analysis and the area under the receiver operating characteristic curve.Results1.Through literature search,a total of 11 literatures were included,including 8 kinds of test scales.According to the research frequency,reliability and validity of the scales,the analysis and summary concluded that the four scales,named TUG,BBS,SLS and Brief-BESTest were suitable for COPD patients to perform balance function tests.2.A total of 96 patients were included in this study,including 42 patients with a history of falls and 54 patients without a history of falls.The cross-validation accuracy of SLS,TUG,BBS and Brief-BESTest were 51.16%,60.47%,68.60%,72.09%.The area under ROC curve of Brief-BESTest(0.808)was the highest compared with that of BBS(0.776),TUG(0.678)and SLS(0.594).At the cutoff score of 14,the Brief-BESTest demonstrated a posttest accuracy with a sensitivity of 0.778 and specificity of 0.762.Conclusions1.The use of balance function test scale in elderly COPD patients was summarized by evidence-based research.2.Through evidence clinical application research,brief-BESTEST was the best at screening a history of falls in COPD patients.Recommended clinical selection of using Brief-BESTest to assess balance and predict fall risk in COPD patients with limited time and space.