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A randomized controlled trial of balance training during pulmonary rehabilitation for individuals with COPD
Beauchamp MK, Janaudis-Ferreira T, Parreira V, Romano JM, Woon L, Goldstein RS, Brooks D
Chest 2013 Dec;144(6):1803-1810
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 < 0.01), BESTest (p < 0.01), PF-10 (p = 0.01), and 30-s chair-stand (p = 0.02) were significantly improved in the intervention group. No significant between-group differences were found in change scores on the ABC scale (p = 0.2). 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; number NCT01424098; URL www.ClinicalTrials.gov.

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