Role of Muscle Strength in Balance Assessment and Treatment in Chronic Obstructive Pulmonary Disease

Purpose: The purpose of this review is to examine the role of muscle strength in the assessment and management of balance problems among individuals with chronic obstructive pulmonary disease (COPD). Our specific aims are to (1) synthesize the literature on the role of muscle strength in balance control among older adults; (2) provide an overview of what is known about these relationships in people with COPD; and (3) describe clinical applications of assessing and training muscle strength in the context of improving balance among individuals with COPD. Summary of Key Points: Muscle strength is a key contributor to balance in both healthy populations and in people with COPD. Although impairments in skeletal muscle have been well studied in people with COPD, the contributions of this dysfunction to the observed balance deficits in COPD has not been as well studied to date. Furthermore, current research only supports associations between muscle strength and balance performance, and we are unable to determine cause and effect. Future research should address the impact of potential deficits in muscle power and endurance on postural control and fall risk in people with COPD. Recommendations: Comprehensive assessment of balance in people with COPD should include an assessment of muscle strength but also cannot ignore the many other subsystems underlying balance. When targeting muscle strength as part of a balance training program, specific considerations should be given to functional lower-body and core exercises that challenge different balance systems.