Annemarie Lee

Annemarie Lee

Postdoctoral research fellow
West Park Healthcare Centre

Title: Forgotten Co-morbidities in COPD


Roger Goldstein is the Director of the Respiratory program at West Park Healthcare Centre and a Professor of Medicine at the University of Toronto. His research
interests include chronic respiratory disease, exercise training and pulmonary rehabilitation. Dr Annemarie Lee is a postdoctoral research fellow at West Park
Healthcare Centre and a physiotherapist in pulmonary rehabilitation, with an interest in comorbidities in COPD, including pain and gastro-oesophageal reflux. She
has published more than 50 papers in peer reviewed journals.


Chronic obstructive pulmonary disease (COPD) is a complex multi-component condition whose clinical presentation is often complicated by co-morbidities and extrapulmonary clinical features. This presentation will highlight three of them. Affecting between 17% and 78% of people is gastro-oesophageal reflux disease (GORD). Due to the possibility of pulmonary microaspiration GORD may influence lung disease severity and is a predictor of acute exacerbations. Pain is common in people with COPD, affecting 66% of individuals with moderate to very severe disease. Higher pain intensity is associated with increased dyspnea, fatigue, poorer quality of life, lower levels of physical activity and a greater number of comorbidities. Pain imposes limitations on exercise behaviour and participation in pulmonary rehabilitation. The common locations of pain are the upper and lower back and lower limbs. In COPD, postural alterations may be influenced by musculoskeletal comorbidities including osteoarthritis and osteoporosis. Common postural abnormalities include alterations in the degree of cervical lordosis and thoracic kyphosis, and altered scapula position. Postural alterations are associated with reduced pulmonary function and may contribute to exercise limitations and increased functional impairment.

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