A Comparison of Balance in a Smoker and Never-Smoker Barber RJ, Yentes JM Department Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182 INTRODUCTION RESULTS Smoker Patients with chronic obstructive pulmonary disease (COPD) have muscle weakness and an increase in muscle fatigue(1). There is a compromise in balance in patients with COPD, which has been associated with an increased risk of falls(2). Laboratory balance tests have indicated that balance in the medio-lateral (i.e., side-to-side) direction is altered and is further altered when sensory systems are altered in patients with COPD (e.g. eyes closed or uneven surface )(5). Smoking has been shown to be a risk factor for developing COPD(3) and can lead to oxidative stress and muscle dysfunction(4). This research was to determine if those at risk for developing COPD already have a deficit in balance. Never-Smoker (A) Time (Seconds) Time (Seconds) (B) METHODS Time (Seconds) Time (Seconds) (C) Two female subjects, ages 40 years ±6 years participated. One smoker, with a history of smoking for 20 years, 15 cigarettes per day ±5 cigarettes. One never-smoker had no history of smoking. Subjects completed three, 30 second trials: normal standing, on an uneven surface using an Airex® balance pad (Figure 1), and with eyes closed on the balance pad. Joint range of motion (ROM) and center of pressure sway was measured in all three conditions. Time (Seconds) Time (Seconds) Figure 3. Sway in meters vs time in seconds graphs show a greater frequency and smaller amplitude in medio-lateral sway normal standing (A) for the smoker as opposed to the never-smoker. Both the smoker and never-smoker increase frequency of sway as sensory information is further disrupted with standing on an uneven surface (B), and eyes closed while standing on an uneven surface (C). The never-smoker shows discreet adjustments in individual foot sway as the subject shifts from one foot to another, while the smoker has greater fluctuations in both feet without shifting between feet. Figure 1. Airex® balance pad is a foam device typically used for rehabilitation purposes of balance training. The foam surface reduces stability, therefore increasing the need for proprioceptive input. CONCLUSIONS There is a difference in medio-lateral sway when comparing the smoker to the non-smoker which may indicate a difference in maintenance and possible deficits in balance for the smoker. The increased sway frequency for the smoker could indicate an inability to accurately maintain balance without frequent adjustments. The difference in medio-lateral sway for the smoker is consistent with previous research(5) which has been shown in patients with COPD , and this difference could be a considered a deficit in balance for those at risk of developing COPD. RESULTS Figure 2. The smoker has a less ROM during sway, in all joints, when compared to the never-smoker. Both the subjects show the greatest range of motion in the ankle compared to the other joints. ROM continually decreases for both subjects from joint to joint, ankle to hip. REFERENCES ( 1) Gagnon et al. (2013). COPD, 10(2), 235-42. (4) Barreiro et al. (2010). American J. Resp. Crit. Care Med., 182(4), 477-88. (2) Beauchamp et al. (2009). Resp. Med., 103, 1885-91. (3) CDC. (2005). MMWR, 54, 625-8. (5) Smith et al. (2010). Gait Posture, 31, 456-60.