Pulmonar disease post-tuberculose: Evaluation of the body balance and his correlation with functional capacity, pulmonar function and musculary function

Abstract

Introduction: Tuberculosis is an infectious disease that, despite being cured, can leave structural and functional sequelae in the lungs, resulting in a condition known as post-tuberculosis lung disease (PTLD). Since individuals with PTLD may present with deterioration of lung function, impaired muscle strength, and decreased functional capacity, it becomes essential to assess whether these alterations may impact body balance. Because falls can lead to loss of autonomy, assessing fall risk is an important health issue. This study aimed to evaluate balance control (BC) in individuals with PTLD and correlate it with functional capacity during exertion (FCE), pulmonary function, muscle strength, and fatigue. Methods: This cross-sectional study assessed BC using Berg Balance Scale (BBS), Tinetti Balance Scale (TBS), and Timed "Up and Go" test (TUGT). Pulmonary function, handgrip strength (HGS), quadriceps muscle strength (QMS), fatigue, and six-minute step test (6MST) were performed. Results: Of the 50 iwPTLD evaluated, 34 (68%) were women with a mean age of 50.8±15.4 years. The median body mass index (BMI) and time since the end of PTB treatment were 25.2 ± 6.7 kg/m² and 24 (18–30) months, respectively. Thirteen (26%) of the iwPTLD had a history of smoking, with an average smoking load of 14 (6–23) pack-years. 66%, 38%, and 46% had a BBS, TBS, and TUGT, respectively (moderate/high risk of falls). The degree of agreement between BC classifications was weak-poor (Kappa=0.15–0.35). BBS correlated with QMS (rs=0.373, P=0.007) and 6MST (rs=0.290, P=0.041). TBS correlated with fatigue (rs=0.376, P=0.016), HGS (rs=0.325, P=0.021), QMS (rs=0.291, P=0.040), and 6MST (rs=0.310, P=0.028). TUGT correlated with fatigue (rs=-0.340, P=0.015), pulmonary hyperinflation (rs=-0.500, P=0.0004), HGS (rs=-0.335, P=0.017), QMS (rs=-0.641, P<0.0001), and 6MST (rs=0.696, P<0.0001). Conclusions: In iwPTLD, the BC appears damaged, with alterations observed in up to two-thirds of cases. In these individuals, the worse the BC, the greater the pulmonary hyperinflation and the poorer the peripheral muscle strength and FCE.