Busaba Chuatrakoon1, Shirley Pc Ngai2, Somporn Sungkarat1, Sureeporn Uthaikhup3. 1. Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand. 2. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong. 3. Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand. Electronic address: sureeporn.uthaikhup@cmu.ac.th.
Abstract
OBJECTIVE: To systematically review the evidence for balance impairment and effectiveness of interventions on balance in people with Chronic Obstructive Pulmonary Disease (COPD). DATA SOURCES: Four electronic databases [Scopus, CINAHL, PubMed, and Cochrane Library databases] were searched from inception until June 30, 2019. STUDY SELECTION: Two reviewers independently searched with keywords focusing on COPD, postural control, and exercise. Cross-sectional studies related to balance and randomized controlled trials (RCTs) related to the effectiveness of exercise intervention on balance outcomes were included. DATA EXTRACTION: Two reviewers independently extracted data of balance impairment on participants, exercise training on balance outcome measures. Methodological quality of cross-sectional studies was assessed using the National Institutes of Health (NIH) Quality Assessment Tool. Methodological quality of RCTs was assessed using the Physiotherapy Evidence Database (PEDro) scale and bias was analysed using the Cochrane risk of bias. DATA SYNTHESIS: A narrative review with descriptive synthesis was used. Fifteen cross-sectional studies and four RCTs met the final inclusion criteria. The quality of ten cross-sectional studies were rated as moderate to high (NIH score≥7). Most studies demonstrated impaired balance in people with COPD compared with controls. The quality of all included RCTs was good to excellent (PEDro score=6-9). One RCT had a low risk of bias. Generally, pulmonary rehabilitation (PR) program combined with balance training, Tai Chi, and cycling exercise showed significant improvement in balance in people with COPD. CONCLUSIONS: Impaired balance is evident in people with COPD. Available RCTs suggest that exercise interventions may improve balance performance in COPD patients. However, more research on the effect of exercise interventions on balance in COPD patients is still required.
OBJECTIVE: To systematically review the evidence for balance impairment and effectiveness of interventions on balance in people with Chronic Obstructive Pulmonary Disease (COPD). DATA SOURCES: Four electronic databases [Scopus, CINAHL, PubMed, and Cochrane Library databases] were searched from inception until June 30, 2019. STUDY SELECTION: Two reviewers independently searched with keywords focusing on COPD, postural control, and exercise. Cross-sectional studies related to balance and randomized controlled trials (RCTs) related to the effectiveness of exercise intervention on balance outcomes were included. DATA EXTRACTION: Two reviewers independently extracted data of balance impairment on participants, exercise training on balance outcome measures. Methodological quality of cross-sectional studies was assessed using the National Institutes of Health (NIH) Quality Assessment Tool. Methodological quality of RCTs was assessed using the Physiotherapy Evidence Database (PEDro) scale and bias was analysed using the Cochrane risk of bias. DATA SYNTHESIS: A narrative review with descriptive synthesis was used. Fifteen cross-sectional studies and four RCTs met the final inclusion criteria. The quality of ten cross-sectional studies were rated as moderate to high (NIH score≥7). Most studies demonstrated impaired balance in people with COPD compared with controls. The quality of all included RCTs was good to excellent (PEDro score=6-9). One RCT had a low risk of bias. Generally, pulmonary rehabilitation (PR) program combined with balance training, Tai Chi, and cycling exercise showed significant improvement in balance in people with COPD. CONCLUSIONS: Impaired balance is evident in people with COPD. Available RCTs suggest that exercise interventions may improve balance performance in COPDpatients. However, more research on the effect of exercise interventions on balance in COPDpatients is still required.
Authors: Rainer Gloeckl; Tessa Schneeberger; Daniela Leitl; Tobias Reinold; Christoph Nell; Inga Jarosch; Klaus Kenn; Andreas R Koczulla Journal: Respir Res Date: 2021-05-04