Postural Control in Lowlanders With COPD Traveling to 3100 m: Data From a Randomized Trial Evaluating the Effect of Preventive Dexamethasone Treatment
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...
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Frontiers Media S.A.
2018-06-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphys.2018.00752/full |
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| author | Lara Muralt Lara Muralt Michael Furian Michael Furian Mona Lichtblau Mona Lichtblau Sayaka S. Aeschbacher Sayaka S. Aeschbacher Ross A. Clark Bermet Estebesova Bermet Estebesova Ulan Sheraliev Ulan Sheraliev Nuriddin Marazhapov Nuriddin Marazhapov Batyr Osmonov Batyr Osmonov Maya Bisang Maya Bisang Stefanie Ulrich Stefanie Ulrich Tsogyal D. Latshang Tsogyal D. Latshang Silvia Ulrich Silvia Ulrich Talant M. Sooronbaev Talant M. Sooronbaev Konrad E. Bloch Konrad E. Bloch Konrad E. Bloch |
| author_facet | Lara Muralt Lara Muralt Michael Furian Michael Furian Mona Lichtblau Mona Lichtblau Sayaka S. Aeschbacher Sayaka S. Aeschbacher Ross A. Clark Bermet Estebesova Bermet Estebesova Ulan Sheraliev Ulan Sheraliev Nuriddin Marazhapov Nuriddin Marazhapov Batyr Osmonov Batyr Osmonov Maya Bisang Maya Bisang Stefanie Ulrich Stefanie Ulrich Tsogyal D. Latshang Tsogyal D. Latshang Silvia Ulrich Silvia Ulrich Talant M. Sooronbaev Talant M. Sooronbaev Konrad E. Bloch Konrad E. Bloch Konrad E. Bloch |
| author_sort | Lara Muralt |
| collection | DOAJ |
| description | 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 years, living near Bishkek (760 m), were randomized to receive either dexamethasone (2 × 4 mg/day 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 1 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 -0.4 to 3.6, P = 0.925), even when controlled for several potential confounders. PL changes were related more to antero-posterior than lateral sway. Twenty-two 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.Conclusion: 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.Trial Registration:clinicaltrials.gov Identifier: NCT02450968. |
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| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-04-13T07:38:25Z |
| publishDate | 2018-06-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj.art-d759fd10eac24323a5cdf28bee6b46282022-12-22T02:56:01ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2018-06-01910.3389/fphys.2018.00752367985Postural Control in Lowlanders With COPD Traveling to 3100 m: Data From a Randomized Trial Evaluating the Effect of Preventive Dexamethasone TreatmentLara Muralt0Lara Muralt1Michael Furian2Michael Furian3Mona Lichtblau4Mona Lichtblau5Sayaka S. Aeschbacher6Sayaka S. Aeschbacher7Ross A. Clark8Bermet Estebesova9Bermet Estebesova10Ulan Sheraliev11Ulan Sheraliev12Nuriddin Marazhapov13Nuriddin Marazhapov14Batyr Osmonov15Batyr Osmonov16Maya Bisang17Maya Bisang18Stefanie Ulrich19Stefanie Ulrich20Tsogyal D. Latshang21Tsogyal D. Latshang22Silvia Ulrich23Silvia Ulrich24Talant M. Sooronbaev25Talant M. Sooronbaev26Konrad E. Bloch27Konrad E. Bloch28Konrad E. Bloch29Department of Respiratory Medicine, University Hospital Zurich, Zurich, SwitzerlandKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, University Hospital Zurich, Zurich, SwitzerlandKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, University Hospital Zurich, Zurich, SwitzerlandKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, University Hospital Zurich, Zurich, SwitzerlandKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanSchool of Health and Sports Science, University of the Sunshine Coast, Sunshine Coast, QLD, AustraliaKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, KyrgyzstanKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, KyrgyzstanKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, KyrgyzstanKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, KyrgyzstanDepartment of Respiratory Medicine, University Hospital Zurich, Zurich, SwitzerlandKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, University Hospital Zurich, Zurich, SwitzerlandKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, University Hospital Zurich, Zurich, SwitzerlandKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, University Hospital Zurich, Zurich, SwitzerlandKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, KyrgyzstanDepartment of Respiratory Medicine, University Hospital Zurich, Zurich, SwitzerlandKyrgyz-Swiss High Altitude Clinic and Medical Research Center, Tuja-Ashu, KyrgyzstanDepartment of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, KyrgyzstanObjective: 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 years, living near Bishkek (760 m), were randomized to receive either dexamethasone (2 × 4 mg/day 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 1 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 -0.4 to 3.6, P = 0.925), even when controlled for several potential confounders. PL changes were related more to antero-posterior than lateral sway. Twenty-two 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.Conclusion: 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.Trial Registration:clinicaltrials.gov Identifier: NCT02450968.https://www.frontiersin.org/article/10.3389/fphys.2018.00752/fullchronic obstructive pulmonary diseasealtitudehypoxiapostural controldexamethasoneacute mountain sickness |
| spellingShingle | Lara Muralt Lara Muralt Michael Furian Michael Furian Mona Lichtblau Mona Lichtblau Sayaka S. Aeschbacher Sayaka S. Aeschbacher Ross A. Clark Bermet Estebesova Bermet Estebesova Ulan Sheraliev Ulan Sheraliev Nuriddin Marazhapov Nuriddin Marazhapov Batyr Osmonov Batyr Osmonov Maya Bisang Maya Bisang Stefanie Ulrich Stefanie Ulrich Tsogyal D. Latshang Tsogyal D. Latshang Silvia Ulrich Silvia Ulrich Talant M. Sooronbaev Talant M. Sooronbaev Konrad E. Bloch Konrad E. Bloch Konrad E. Bloch Postural Control in Lowlanders With COPD Traveling to 3100 m: Data From a Randomized Trial Evaluating the Effect of Preventive Dexamethasone Treatment Frontiers in Physiology chronic obstructive pulmonary disease altitude hypoxia postural control dexamethasone acute mountain sickness |
| title | Postural Control in Lowlanders With COPD Traveling to 3100 m: Data From a Randomized Trial Evaluating the Effect of Preventive Dexamethasone Treatment |
| title_full | Postural Control in Lowlanders With COPD Traveling to 3100 m: Data From a Randomized Trial Evaluating the Effect of Preventive Dexamethasone Treatment |
| title_fullStr | Postural Control in Lowlanders With COPD Traveling to 3100 m: Data From a Randomized Trial Evaluating the Effect of Preventive Dexamethasone Treatment |
| title_full_unstemmed | Postural Control in Lowlanders With COPD Traveling to 3100 m: Data From a Randomized Trial Evaluating the Effect of Preventive Dexamethasone Treatment |
| title_short | Postural Control in Lowlanders With COPD Traveling to 3100 m: Data From a Randomized Trial Evaluating the Effect of Preventive Dexamethasone Treatment |
| title_sort | postural control in lowlanders with copd traveling to 3100 m data from a randomized trial evaluating the effect of preventive dexamethasone treatment |
| topic | chronic obstructive pulmonary disease altitude hypoxia postural control dexamethasone acute mountain sickness |
| url | https://www.frontiersin.org/article/10.3389/fphys.2018.00752/full |
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