A Randomized Controlled Trial of Balance Training During Pulmonary Rehabilitation for Individuals With COPD

BACKGROUND: Deficits in balance are increasingly recognized among the important secondary impairments in COPD. The purpose of this study was to investigate the effect of a balance-training program on measures of balance and physical function in patients with COPD enrolled in pulmonary rehabilitation (PR). METHODS: Patients were assigned randomly to an intervention or control group. The intervention group underwent balance training three times a week for 6 weeks concurrently with PR. The control group received only the 6-week PR program. Clinical balance measures included the Berg Balance Scale (BBS), the Balance Evaluation Systems Test (BESTest), and the Activities-Specific Balance Confidence (ABC) scale. The physical function subscale of the 36-Item Short Form Health Survey (PF-10) and the 30-s chair-stand test were used to measure self-reported physical function and lower-extremity muscle strength, respectively. RESULTS: Thirty-nine patients with COPD (mean FEV1, 37.5% ± 15.6% predicted) were enrolled in the study. Mean compliance with the balance-training program was 82.5%, and no adverse events were reported. Compared with control subjects, scores on the BBS (P < .01), BESTest (P < .01), PF-10 (P = .01), and 30-s chair-stand (P = .02) were significantly improved in the intervention group. No significant between-group differences were found in change scores on the ABC scale (P = .2). CONCLUSIONS: Our results support the feasibility and effectiveness of balance training as part of PR for improving balance performance, muscle strength, and self-reported physical function in patients with moderate to severe COPD.