Abstract:
Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory
condition that frequently leads to lower limb muscle weakness and compromised balance. The
hamstrings-to-quadriceps (H:Q) strength ratio is a crucial clinical measure that significantly
contributes to postural stability. However, there is a lack of data regarding the relationship
between the H:Q ratio and balance in COPD patients in Sri Lanka.
Objectives: To assess the relationship between H:Q ratio and balance among COPD patients at
Central Chest Clinic, Colombo
Methods: A cross-sectional study was conducted at the Central Chest Clinic, involving 138
COPD patients selected by convenient sampling, aged between 35-75 years. Demographic
information was gathered using an interviewer-administered questionnaire. The isometric strength
of the quadriceps and hamstrings were measured using a hand-held dynamometer, and the H:Q
strength ratios were calculated for both dominant and non-dominant limbs. The Berg Balance
Scale (BBS) was employed to assess functional balance. Data analysis was performed using
Spearman correlation with SPSS version 25.0.
Results: The mean±SD age of the participants was 63.6±6.7 years with a majority of males
(n=113, 81.9%). The mean±SD H:Q strength ratio for the dominant and non-dominant sides were
0.65±0.2, while the mean±SD BBS score was 42.6±11.6. A significant positive correlation was
observed in the BBS score with the H:Q ratio of dominant (r=0.41, p=0.000) and non-dominant
sides (r=0.28, p=0.001).
Conclusions: The study revealed a strong positive relationship between H:Q ratio and balance in
patients with COPD. This underscores the importance of lower limb muscle strength in
maintaining balance. Hence, incorporating strength training exercises for the hamstrings and
quadriceps into pulmonary rehabilitation could enhance balance in this population.
