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Original Research: COPD |

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

Marla K. Beauchamp, PhD, PT; Tania Janaudis-Ferreira, PhD; Verônica Parreira, PhD; Julia M. Romano, MSc; Lynda Woon, BSc, PT; Roger S. Goldstein, MD, FCCP; Dina Brooks, PhD, PT
Author and Funding Information

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.

Correspondence to: Dina Brooks, PhD, PT, Department of Physical Therapy, University of Toronto, 160-500 University Ave, Toronto, ON, M5G 1V7, Canada; e-mail: dina.brooks@utoronto.ca


An abstract of this work was accepted for oral presentation at the 2013 American Thoracic Society International Conference, May 17-22, 2013, Philadelphia, PA.

Funding/Support: Dr Beauchamp is supported by a fellowship from the Canadian Institutes of Health Research; Dr Parreira by Coordination for Enhancement of Higher Education Personnel – Brazil; Dr Goldstein by the University of Toronto, National Sanitarium Association Chair in Respiratory Rehabilitation Research; and Dr Brooks by a Canada Research Chair. Funding for this study was provided by the Ontario Thoracic Society of the Ontario Lung Association.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(6):1803-1810. doi:10.1378/chest.13-1093
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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

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