Effect of Pulmonary Rehabilitation on Balance in Persons With Chronic Obstructive Pulmonary Disease

OBJECTIVES: To describe within-subject effects of pulmonary rehabilitation (PR) on balance in persons with chronic obstructive pulmonary disease (COPD) and to determine whether any observed changes in balance were associated with change in exercise tolerance or health-related quality of life. DESIGN: Single-arm longitudinal study. SETTING: Inpatient PR center. PARTICIPANTS: Subjects with COPD (N=29; mean +/- SD age, 69.8+/-10.3y; forced expiratory volume in 1 second, 46.3%+/-22.3% predicted; 59% men [n=17]). INTERVENTIONS: A standardized 6-week multidisciplinary PR program (exercise training, breathing exercises, education, and psychologic support). MAIN OUTCOME MEASURES: Balance was assessed using the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and the Activities-Specific Balance Confidence (ABC) scale. Exercise tolerance was determined from the 6-minute walk test (6MWT), and health-related quality of life from the Chronic Respiratory Questionnaire (CRQ). RESULTS: Subjects showed small improvements in BBS (2.8+/-2.8 points; P<.001) and TUG (-1.5+/-2.4s; P=.003) scores, but not in ABC scores (4.8+/-15.4 points; P>.05). There was a weak relationship between change in BBS and change in CRQ scores (r=.40; P=.045) and no relationship with change in 6MWT. CONCLUSIONS: PR contributed to minor improvements in balance and had no effect on balance confidence in subjects with COPD. Further work is warranted to determine the optimal intervention for improving balance in this population.