From the Department of Physical Medicine and Rehabilitation (Dr Beauchamp), Harvard Medical School, Spaulding Rehabilitation Hospital, Cambridge, MA; Respiratory Medicine (Drs Beauchamp, Janaudis-Ferreira, Parreira, Goldstein, and Brooks, and Mss Romano and Woon), West Park Healthcare Centre, Toronto, ON, Canada; Sunnybrook Research Institute (Dr Janaudis-Ferreira), Sunnybrook Health Sciences Centre, St. John’s Rehab Program, Toronto, ON, Canada; and the Department of Physical Therapy (Drs Janaudis-Ferreira, Goldstein, and Brooks) and the Department of Medicine (Dr Goldstein), University of Toronto, Toronto, ON, Canada.
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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.Trial registry:ClinicalTrials.gov; No.: NCT01424098; URL: www.clinicaltrials.gov