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Balance training: its influence on pulmonary rehabilitation
Bulletin of Faculty of Physical Therapy volume 24, pages 8–13 (2019)
Abstract
Background
Balance disorders are one of the most important complications for patients with chronic obstructive pulmonary disease (COPD).
Objective
To investigate the effect of adding balance training to pulmonary rehabilitation program in improving balance in patients with COPD.
Patients and methods
A total of 48 male patients diagnosed as having COPD were selected from the outpatient clinic of Wadi El-Neel Hospital, Cairo, and their ages ranged from 60 to 65 years. Patients were assigned randomly into two equal groups. The study group received balance training with pulmonary rehabilitation program, and the control group received pulmonary rehabilitation program only. Exercise training was performed for both groups three times a week for 8 weeks. Balance assessment was performed by Berg Balance Scale, Balance Evaluation Systems Test, and 6-min walking test before and after training.
Results
The 2×2 mixed-model analysis of variance analysis demonstrated significant increase in the Berg Balance Scale and Balance Evaluation Systems Test after treatment in both groups, with a percentage of improvement in control group was 5.01 and 9.15%, respectively, whereas in the study group was 16.04 and 25.46%, respectively. However, the study group showed significant improvement than the control group after treatment in both tests. Regarding 6-min walking test, both groups showed significant increase after treatment, with a similar percentage of improvement in the control group (23.95%) and the study group (24.93%). There was no significant difference between the control and the study group after treatment.
Conclusion
Addition of balance training to pulmonary rehabilitation program was more effective in improving balance in elderly patients with COPD.
References
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease- report 2018. http://goldcopd.org/wpcontent/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf
Rachael AE, Eric K, Marla KB, Thomas ED, Roger SG, Clare LG, et al. Is quadriceps endurance reduced in COPD? a systematic review. Chest 2015; 147: 673–684.
Joaquim G, Sergi P, Carme C, Mauricio OL, Esther B. Muscle dysfunction in chronic obstructive pulmonary disease: update on causes and biological findings. J Thorac Dis 2015; 7: E418– E438.
American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001; 49:664–672.
Tinetti ME, Mendes de Leon CF, Doucette JT, Baker DI. Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. J Gerontol 1994; 49:M140–M147.
Marla KB, Dina Cindy E, Annemarie L, Jennifer A, Pat GC, et al. Pulmonary rehabilitation with balance training for fall reduction in chronic obstructive pulmonary disease: protocol for a randomized controlled trial. JMIR Res Protoc 2017; 6:1–11.
Roig M, Eng JJ, MacIntyre DL, Road JD, FitzGerald JM, Burns J, et al. Falls in people with chronic obstructive pulmonary disease: an observational cohort study. Respir Med 2011; 105:461–469.
Jørgensen TSH, Hansen AH, Sahlberg M, Gislason GH, Torp-Pedersen C, Andersson C, et al. Nationwide time trends and risk factors for in-hospital falls-related major injuries. Int J Clin Pract 2015; 69:703–709.
Celli BR, MacNee W, Agusti A, Anzueto A, Berg B, Buist AS, et al. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004; 23:932–946.
Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. Task force on pulmonary rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013; 188: e13–e64.
Kenney RA, Rubenstein LZ, Tinetti ME, Brewer K, Cameron KA, Capezuti EA, et al. Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc 2011; 59:148–157.
Finch E, Brooks D, Stratford P, Mayo N. Physical rehabilitation outcome measures: a guide to enhanced clinical-decision-making. 2nd ed. Hamilton, Canada: Canadian Physiotherapy Association; 2002.
Horak FB, Wrisley DM, Frank J. The Balance Evaluation Systems Test (BESTest) to differentiate balance defi cits. Phys Ther 2009; 89:484–498.
Welkowitz J, Ewen RB, Cohen J. Introductory statistics for the behavioral sciences. 3rd ed. San Diego, CA: Harcourt Brace Jovanovich; 1982.
American Thoracic Society-European Respiratory Society Statement. Skeletal muscle dysfunction in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999; 159:1s–28s.
Smith MD, Chang AT, Seale HE, Walsh JR, Hodges PW. Balance is impaired in people with chronic obstructive pulmonary disease. Gait Posture 2010; 31:456–460.
Sabit R, Bolton CE, Edwards PH, Pettit RJ, Evans WD, McEniery CM, et al. Arterial stiffness and osteoporosis in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2007; 175:1259–1265.
Butcher SJ, Meshke JM, Sheppard MS. Reductions in functional balance, coordination, and mobility measures among patients with stable chronic obstructive pulmonary disease. J Cardiopulm Rehabil 2004; 24:274–280.
Eisner MD, Iribarren C, Blanc PD, Yelin EH, Ackerson L, Byl N, et al. Development of disability in chronic obstructive pulmonary disease: beyond lung function. Thorax 2011; 66:108–114.
Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C. Exercise for improving balance in older people. Cochrane Database Syst Rev 2011; 11:CD004963.
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2009 2:CD007146.
Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med 2017; 51:1750–1758.
[No autjors listed]. Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc 2001; 49:664–672.
Chang AT, Seale H, Walsh J, Brauer SG. Static balance is affected following an exercise task in chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev 2008; 28:142–145.
Beauchamp MK, Janaudis-Ferreira T, Parreira V, Romano JM, Woon L, Goldstein RS, et al. A randomized control trial of balance training during pulmonary rehabilitation for individuals with COPD. Chest 2013; 144:1803–1810.
Haley SM, Fragala-Pinkham MA. Interpreting change scores of tests and measures used in physical therapy. Phys Ther 2006; 86:735–743.
Orr R. Contribution of muscle weakness to postural instability in the elderly. A systematic review. Eur J Phys Rehabil Med 2010; 46:183–220.
Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc 2008; 56:2234–2243.
Brooks D, Sottana R, Bell B, Hanna M, Laframboise L, Selvanayagarajah S, et al. Characterization of pulmonary rehabilitation programs in Canada in 2005. Can Respir J 2007; 14:87–92.
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Mounir, K., Elserty, N. & Obaya, H. Balance training: its influence on pulmonary rehabilitation. Bull Fac Phys Ther 24, 8–13 (2019). https://doi.org/10.4103/bfpt.bfpt_14_18
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DOI: https://doi.org/10.4103/bfpt.bfpt_14_18