Introduction: Gait characteristics are important risk factors for falls, hospitalisations, and mortality in older adults, but the impact of COPD on gait performance remains unclear. We aimed to identify differences in gait characteristics between adults with COPD and healthy age-matched controls during (1) laboratory tests that included complex movements and obstacles, (2) simulated daily-life activities (supervised), and (3) free-living daily-life activities (unsupervised).

Methods: A multi-sensor wearable system (INDIP) was used to obtain seven gait characteristics for each walking bout performed by adults with mild-to-severe COPD (n=17; forced expiratory volume in one second=57±19 %predicted) and controls (n=20) during laboratory tests, and during simulated and free-living daily-life activities. Gait characteristics were compared between adults with COPD and healthy controls for all walking bouts combined, and for short (?30 s) and long (>30s) walking bouts separately.

Results: Lower walking speed (-11 cm/s, 95%CI: -20 to -3) and cadence (-6.6 steps/min, 95%CI: -12.3 to -0.9) were recorded in adults with COPD compared to healthy controls during long (>30 s) free-living walking bouts, but not during short (?30 s) walking bouts in either laboratory or free-living settings. Double support duration and gait variability measures were generally comparable between the two groups.

Conclusion: Gait impairment of adults with COPD mainly manifests during relatively long walking bouts (>30 s) in free-living conditions. Future research should determine the underlying mechanism(s) of this impairment to facilitate the development of interventions that can improve free-living gait performance in adults with COPD.