Journal article
Postural control in lowlanders with COPD travelling to 3100 m; data from a randomized trial evaluating the effect of preventive dexamethasone treatment
Frontiers in Physiology, Vol.9, 752
2018
Abstract
Objective: To evaluate the effects of acute exposure to high altitude and preventive dexamethasone treatment on postural control in patients with chronic obstructive pulmonary disease (COPD). Methods: In this randomized, double-blind parallel-group trial, 104 lowlanders with COPD GOLD 1-2 age 20-75 y, living near Bishkek (760 m), were randomized to receive either dexamethasone (2x4 mg/d p.o.) or placebo on the day before ascent and during a 2-day sojourn at Tuja-Ashu high altitude clinic (3100 m), Kyrgyzstan. Postural control was assessed with a Wii Balance BoardTM at 760 m and one day after arrival at 3100 m. Patients were instructed to stand immobile on both legs with eyes open during five tests of 30 s each, while the center of pressure path length (PL) was measured. Results: With ascent from 760 to 3100 m the PL increased in the placebo group from median (quartiles) 29.2 (25.8 ; 38.2) to 31.5 (27.3 ; 39.3) cm (P< 0.05); in the dexamethasone group the corresponding increase from 28.8 (22.8 ; 34.5) to 29.9 (25.2 ; 37.0) cm was not significant (P=0.10). The mean difference (95% CI) between dexamethasone and placebo groups in altitude-induced changes (treatment effect) was -0.3 (-3.2 to 2.5) cm, (P=0.41). Multivariable regression analysis confirmed a significant increase in PL with higher altitude (coefficient 1.6, 95% CI 0.2 to 3.1, P=0.031) but no effect of dexamethasone was shown (coefficient -0.2, 95% CI -4.0 to 3.6, P=0.925), even when controlled for several potential confounders. PL changes were related more to antero-posterior than lateral sway. 22 of 104 patients had an altitude-related increase in the antero-posterior sway velocity of >25%, what has been associated with an increased risk of falls in previous studies. Conclusions: Lowlanders with COPD travelling from 760 to 3100 m revealed postural instability 24 h after arriving at high altitude, and this was not prevented by dexamethasone.
Details
- Title
- Postural control in lowlanders with COPD travelling to 3100 m; data from a randomized trial evaluating the effect of preventive dexamethasone treatment
- Authors
- Lara Muralt (Author) - University Hospital Zurich, SwitzerlandMichael Furian (Author) - University Hospital Zurich, SwitzerlandMona Lichtblau (Author) - University Hospital Zurich, SwitzerlandSayaka S Aeschbacher (Author) - University Hospital Zurich, SwitzerlandRoss Clark (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and EngineeringBermet Estebesova (Author) - Kyrgyz-Swiss High Altitude Clinic and Medical Research Center, KyrgyzstanUlan Sheraliev (Author) - Kyrgyz-Swiss High Altitude Clinic and Medical Research Center, KyrgyzstanNiriddin Marazhapov (Author) - Kyrgyz-Swiss High Altitude Clinic and Medical Research Center, KyrgyzstanBatyr Osmonov (Author) - Kyrgyz-Swiss High Altitude Clinic and Medical Research Center, KyrgyzstanMaya Bisang (Author) - Kyrgyz-Swiss High Altitude Clinic and Medical Research Center, KyrgyzstanStefanie Ulrich (Author) - Kyrgyz-Swiss High Altitude Clinic and Medical Research Center, KyrgyzstanTsogyal Latshang (Author) - Kyrgyz-Swiss High Altitude Clinic and Medical Research Center, KyrgyzstanSilvia Ulrich (Author) - Kyrgyz-Swiss High Altitude Clinic and Medical Research Center, KyrgyzstanTalant M Sooronbaev (Author) - Kyrgyz-Swiss High Altitude Clinic and Medical Research Center, KyrgyzstanKonrad E Block (Author) - Kyrgyz-Swiss High Altitude Clinic and Medical Research Center, Kyrgyzstan
- Publication details
- Frontiers in Physiology, Vol.9, 752
- Publisher
- Frontiers Research Foundation
- Date published
- 2018
- DOI
- 10.3389/fphys.2018.00752
- ISSN
- 1664-042X
- Copyright note
- Copyright © 2018 Muralt, Furian, Lichtblau, Aeschbacher, Clark, Estebesova, Sheraliev, Marazhapov, Osmonov, Bisang, Ulrich, Latshang, Ulrich, Sooronbaev and Bloch. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Health and Sport Sciences - Legacy; School of Health and Behavioural Sciences - Legacy; School of Health - Public Health
- Language
- English
- Record Identifier
- 99451423802621
- Output Type
- Journal article
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