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Existing evidence suggests that single\u2010visit assessments have limited and inconsistent ability to predict the future falls in individuals with COPD, highlighting the need for alternative longitudinal approaches. To our knowledge, this is the first prospective study to explore the longitudinal association between diary\u2010recorded symptoms and falls in COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Prospective observational cohort pilot study (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a027), with 6\u2010month follow\u2010up. Falls and seven symptom variables were recorded monthly via structured home diaries, complemented by a standardised monthly telephone\/messaging follow\u2010up. Receiver operating characteristic (ROC) curves with 95% bootstrap confidence intervals (CI) and optimal cut\u2010off points using the Youden index were calculated, with internal validation by optimism\u2010correction bootstrap. Mann\u2013Whitney U tests compared groups (\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u00a0=\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen patients (48.1%) experienced at least one fall. Dizziness showed the strongest discrimination in this sample (area under the ROC curve [AUC]\u00a0=\u00a00.813; optimism\u2010corrected 0.81;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002; optimal cut\u2010off \u2265\u00a01\u00a0month; specificity 85.7%; positive likelihood ratio [+LR] 4.84). Lower limb weakness for \u2265\u00a02\u00a0months was the most sensitive discriminating variable (AUC\u00a0=\u00a00.739;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.034; sensitivity 92.3%). Among baseline physiological measures, only the FEV1\/FVC ratio showed acceptable discrimination (AUC\u00a0=\u00a00.734;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.041), in a paradoxical direction (higher among fallers); Timed Up and Go, maximal inspiratory pressure, and quadriceps ultrasound did not significantly discriminate fallers from non\u2010fallers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Longitudinal symptom monitoring via monthly home diaries showed higher apparent discrimination than single\u2010visit baseline assessments in this pilot sample. These findings are exploratory and hypothesis\u2010generating, supporting a confirmatory study with an adequate sample size. Monthly diary monitoring is low\u2010cost, feasible by telephone, and may represent a complementary approach to fall risk assessment in COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Registered on ClinicalTrials.gov, identifier NCT06827379 (PI: Eduardo Eriko Ten\u00f3rio de Fran\u00e7a)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70363","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T08:52:21Z","timestamp":1792659141000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dizziness, Lower Limb Weakness, and Falls in COPD: A Prospective Longitudinal Pilot Study Using Monthly Home Diaries"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9562-3301","authenticated-orcid":false,"given":"Danielle Ferreira de Santana","family":"Silva","sequence":"first","affiliation":[{"name":"Graduate Program in Physical Therapy Federal University of Para\u00edba (UFPB)  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8034-2424","authenticated-orcid":false,"given":"Bianca Maria Santos","family":"Alc\u00e2ntara","sequence":"additional","affiliation":[{"name":"Undergraduate Program in Physical Therapy Federal University of Para\u00edba (UFPB)  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2722-3574","authenticated-orcid":false,"given":"Jefferson Ricardo Santos","family":"da Silva","sequence":"additional","affiliation":[{"name":"Postgraduate in Software Engineering and Quality University Center of Jo\u00e3o Pessoa (UNIP\u00ca)  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9858-2990","authenticated-orcid":false,"given":"Rafaela","family":"Pedrosa","sequence":"additional","affiliation":[{"name":"Graduate Program in Physical Therapy Federal University of Para\u00edba (UFPB)  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9207-2180","authenticated-orcid":false,"given":"Eduardo Eriko Ten\u00f3rio","family":"de Fran\u00e7a","sequence":"additional","affiliation":[{"name":"Graduate Program in Physical Therapy Federal University of Para\u00edba (UFPB)  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Heriston de Morais","family":"Lima","sequence":"additional","affiliation":[{"name":"Graduate Program in Physical Therapy Federal University of Para\u00edba (UFPB)  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/19485506221129160"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11\u20101708"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.54.7.581"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11\u20101708"},{"key":"e_1_2_14_6_1","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J.","year":"1988"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/copd.s50213"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/s22030984"},{"key":"e_1_2_14_9_1","unstructured":"Global Initiative for Chronic Obstructive Lung Disease (GOLD).2025.Global Strategy for the Diagnosis Management and Prevention of Chronic Obstructive Pulmonary Disease. 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