Laboratory and free-living gait performance in adults with COPD and healthy controls

Joren Buekers*, Dimitrios Megaritis, Sarah Koch, Lisa Alcock, Nadir Ammour, Clemens Becker, Stefano Bertuletti, Tecla Bonci, Philip Brown, Ellen Buckley, Sara C. Buttery, Brian Caulfied, Andrea Cereatti, Nikolaos Chynkiamis, Heleen Demeyer, Carlos Echevarria, Anja Frei, Clint Hansen, Jeffrey M. Hausdorff, Nicholas S. HopkinsonEmily Hume, Arne Kuederle, Walter Maetzler, Claudia Mazzà, Encarna M. Micó-Amigo, Arne Mueller, Luca Palmerini, Francesca Salis, Kirsty Scott, Thierry Troosters, Beatrix Vereijken, Henrik Watz, Lynn Rochester, Silvia Del Din, Ioannis Vogiatzis, Judith Garcia-Aymerich

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background Gait characteristics are important risk factors for falls, hospitalisations and mortality in older adults, but the impact of COPD on gait performance remains unclear. We aimed to identify differences in gait characteristics between adults with COPD and healthy age-matched controls during 1) laboratory tests that included complex movements and obstacles, 2) simulated daily-life activities (supervised) and 3) free-living daily-life activities (unsupervised). Methods This case–control study used a multi-sensor wearable system (INDIP) to obtain seven gait characteristics for each walking bout performed by adults with mild-to-severe COPD (n=17; forced expiratory volume in 1 s 57±19% predicted) and controls (n=20) during laboratory tests, and during simulated and free-living daily-life activities. Gait characteristics were compared between adults with COPD and healthy controls for all walking bouts combined, and for shorter (⩽30 s) and longer (>30 s) walking bouts separately. Results Slower walking speed (−11 cm·s−1, 95% CI: −20 to −3) and lower cadence (−6.6 steps·min−1, 95% CI: −12.3 to −0.9) were recorded in adults with COPD compared to healthy controls during longer (>30 s) free-living walking bouts, but not during shorter (⩽30 s) walking bouts in either laboratory or free-living settings. Double support duration and gait variability measures were generally comparable between the two groups. Conclusion Gait impairment of adults with mild-to-severe COPD mainly manifests during relatively long walking bouts (>30 s) in free-living conditions. Future research should determine the underlying mechanism(s) of this impairment to facilitate the development of interventions that can improve free-living gait performance in adults with COPD.

Original languageEnglish
Article number00159-2023
JournalERJ Open Research
Issue number5
StatePublished - 1 Sep 2023


FundersFunder number
Wellcome Trust
Horizon 2020 Framework Programme
European Federation of Pharmaceutical Industries and Associations
Ministerio de Ciencia, Innovación y Universidades
National Institute for Health and Care Research
Department of Health and Social Care
Newcastle University
University of Sheffield
Generalitat de Catalunya
Fonds Wetenschappelijk Onderzoek
Northumberland, Tyne and Wear NHS Foundation Trust
Newcastle upon Tyne Hospitals NHS Foundation Trust
Innovative Medicines Initiative820820, 853981
NIHR Newcastle Biomedical Research Centre
NIHR Imperial Biomedical Research Centre


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