Balance training boosts pulmonary rehabilitation

Sep 2 2013

Canadian researchers report that balance training can significantly improve outcomes when added to pulmonary rehabilitation programs for chronic obstructive pulmonary disease (COPD).

The team, from the West Park Healthcare Centre, in Toronto, Ontario, says that the strategy could reduce the rate of falls, an increasingly recognized risk among patients with the disease, and something that current rehabilitation programs have limited impact on.

Their study involved 39 patients with COPD who had a history of falls or near-falls and were taking part in an inpatient pulmonary rehabilitation program.

Twenty-one patients were assigned to the intervention group, taking part in balance training sessions three times per week for 6 weeks in addition to the standard rehabilitation program. The balance training included stance exercises, transition exercises, gait exercises, and functional strengthening which increased in difficulty as the patients’ ability progressed.

The team found that, despite similar improvements in the 6-minute walk test, patients in the intervention group experienced significantly greater improvements in measures of balance, lower-extremity strength, and self-reported physical function than the 18 patients in the control group, who undertook only standard rehabilitation.

The intervention group had greater change in the Berg Balance Scale score (BBS; mean change 7.0 vs 1.6), Balance Evaluation Systems Test score (15.6 vs 6.0), the number of 30-second chair-stand test repetitions (6.2 vs 2.9), and in the Physical Function scale of the Short Form-36 (18.7 vs 5.6).

Additionally, all patients in the intervention group reported that their balance had improved, with 89.5% saying it was “much better.” This compared with only 11.8% of patients in the control group, with nearly half reporting no improvement in their balance.

And, the researchers observed good compliance with the intervention, at a rate of 82.5% with no adverse events reported.

Writing in Chest, lead author Dina Brooks and colleagues say that their findings suggest clinically meaningful changes in their measures of balance, including a change in BBS score exceeding that which can distinguish fallers from non-fallers.

They say that further studies must explore the effect of the intervention on fall rates in the long term, but nevertheless state that their findings provide “compelling support” for the inclusion of balance training on pulmonary rehabilitation programs for COPD.

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