Effect of balance training within pulmonary rehabilitation

Abstract

Patients with chronic obstructive pulmonary disease (COPD) have balance impairments however, pulmonary rehabilitation (PR) programmes lead to only minor improvements on balance in patients with COPD. Thus, there is a need to explore balance training within PR. This study aimed to determine the effects of balance training within PR among patients with COPD. A quasi-experimental design with outpatients with COPD was conducted. Participants underwent a 12-week PR programme with exercise training (3*week) and psychoeducation (1*week). Each exercise training session incorporated 5 components: warm up (10min), endurance training (20min), strength training (15min), balance training (5min) and cool down (10min). Health-related quality of life (St. George’s Respiratory Questionnaire - SGRQ), quadriceps muscle strength (10 repetition maximum testing) and exercise tolerance (6-minute walk test) were assessed. Balance was determined using the Timed Up and Go (TUG) test. Sixteen outpatients participated (11 males; age 68.2±11.7; FEV1 63.3±19.0%predicted). After PR, there were significant improvements on SGRQ symptoms score (mean change (MC)=12.2 units; p=0.012; effect size (ES)=0.604), quadriceps muscle strength (MC=3.1Kg; p=0.001; ES=1.475) and exercise tolerance (MC=35.7m; p=0.001; ES=1.027). A comparison of TUG test pre- (9.3±2.5s) and post-PR (7.2±1.9s) showed significant improvements (MC=2.1±1.2s; p=0.001; ES=1.834). Before PR 8(50%) participants and after PR only 1(6.3%) had a TUG performance worse than age-matched healthy peers (p=0.004). A specific component of balance training within PR has a large effect on balance in patients with COPD. Further research is needed to determine the optimal intervention for improving balance.