A study characterizes for the first time how people with COPD walk, beyond how much they walk

Walking is a fundamental activity for maintaining health. While numerous studies have assessed how much people with chronic obstructive pulmonary disease (COPD) walk, few have explored how they walk, especially in unsupervised, real-life settings. To fill this gap, researchers at the Barcelona Institute for Global Health (ISGlobal), a centre supported by the ”la Caixa” Foundation, used digital technologies to analyse the walking patterns of individuals with COPD in their daily lives. The study examined parameters such as walking speed, steps per minute, and stride length.

Published in the European Respiratory Journal, the study involved 549 participants with COPD, with an average age of 68, from seven European cities: Athens, Barcelona, Grosshansdorf, Leuven, London, Newcastle, and Zurich. To initially assess participants' gait, researchers used digital tools over a one-week period, combining wearable waist-mounted devices with algorithms specifically tailored for people with limited mobility.

This research is part of the European Mobilise-D project, which aims to enhance the monitoring and care of individuals with mobility impairments through digital gait analysis in everyday environments.

Progressive Gait Impairment

The study’s findings show that gait quality deteriorates as COPD advances. In particular, individuals with more severe breathing difficulties and frequent symptoms or exacerbations exhibited slower walking speeds, shorter steps, and lower step frequencies. Additionally, they demonstrated less variation in walking speed, stride length, and cadence (the number of steps per minute) compared to those with milder forms of the disease.

In a secondary analysis, the gait characteristics of 19 healthy adults of a similar age were evaluated. Comparisons revealed that people with COPD exhibited significantly slower walking speed and cadence than those without COPD.

“Our results suggest that COPD affects not only how much people walk, but also how they walk,” explains Judith Garcia-Aymerich, Director of ISGlobal’s Environment and Health over the Life Course Programme and senior author of the study. “Although we still don’t fully understand the underlying mechanisms, the most pronounced gait impairments in severe cases of COPD may be due to reduced physical capacity caused by symptoms, complications, and chronic inflammation associated with advanced stages of the disease.”

Understanding Gait in Daily Life

The study also revealed that gait parameters such as walking speed, stride length, and cadence were lower than those typically observed in previous studies conducted in clinical or supervised environments. However, these values closely aligned with those reported in the only prior study that assessed gait in daily life without professional supervision.

“This reinforces the idea that COPD negatively impacts mobility in real-world settings. By using wearable sensors over several days, we gain a more accurate picture of how people move in their everyday lives —outside hospitals or rehabilitation centres— which offers a clearer understanding of the disease’s impact,” says Laura Delgado-Ortiz, ISGlobal researcher and lead author of the study

Implications for Clinical Care

These findings could have significant implications for the clinical care of COPD patients. “By recognising and addressing gait changes, healthcare providers may be able to intervene earlier and more effectively to reduce the risks of falls, disability, and mortality in this population,” emphasises Judith Garcia-Aymerich.

Reference

Delgado-Ortiz, L., Buekers, J., Chynkiamis, N., Demeyer, H., Frei, A., et al., Judith Garcia-Aymerich, J. How do people with COPD walk? A European study on digitally measured real-world gait, European Respiratory Journal, 2025, 2402303. Doi: 10.1183/13993003.02303-2024