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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).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This case\u2013control study used a multi-sensor wearable system (INDIP) to obtain seven gait characteristics for each walking bout performed by adults with mild-to-severe COPD (n=17; forced expiratory volume in 1\u2005s 57\u00b119% 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 shorter (\u226430\u2005s) and longer (&gt;30\u2005s) walking bouts separately.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Slower walking speed (\u221211\u2005cm\u00b7s<jats:sup>\u22121<\/jats:sup>, 95% CI: \u221220 to \u22123) and lower cadence (\u22126.6 steps\u00b7min<jats:sup>\u22121<\/jats:sup>, 95% CI: \u221212.3 to \u22120.9) were recorded in adults with COPD compared to healthy controls during longer (&gt;30\u2005s) free-living walking bouts, but not during shorter (\u226430\u2005s) walking bouts in either laboratory or free-living settings. Double support duration and gait variability measures were generally comparable between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Gait impairment of adults with mild-to-severe COPD mainly manifests during relatively long walking bouts (&gt;30\u2005s) 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.<\/jats:p><\/jats:sec>","DOI":"10.1183\/23120541.00159-2023","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T16:14:11Z","timestamp":1692288851000},"page":"00159-2023","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Laboratory and free-living gait performance in adults with COPD and healthy 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