Postural control in COPD patients travelling from 760 m to 3200 m; randomized trial evaluating effects of dexamethasone

Objective: To evaluate effects of acute altitude exposure and of dexamethasone treatment on postural control in patients with COPD. Methods: 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 3-day sojourn at Tuja-Ashu (3200 m), Kyrgyz Republic. Postural control was assessed at 760 m and one day after arrival at 3200 m by letting patients stand on a Wii Balance Board TM recording the center of pressure path length (PL) during 5 trials of 30 s. Results: Ascending from 760 to 3200 m increased the PL in the placebo group from median (quartiles) 29.2 (25.8;38.2) to 31.5 (27.3;39.3) cm (P 25%, what is associated with a two-fold risk of falls in previous studies (Kwok et al. Clin Biomech 2015). Conclusions: In lowlanders with COPD traveling to altitude (3200 m) postural control was impaired 24h after arriving and this was not prevented by dexamethasone. Grant: Swiss National Science Foundation, Lung League Zurich.