Citation

Delbressine JM, Vaes AW, Goërtz YM, Sillen MJ, Kawagoshi A, Meijer K, Janssen DJA, Spruit MA. J. Cardiopulm. Rehabil. Prev. 2020; 40(3): 152-163.

Affiliation

Department of Research and Development, CIRO, Horn, the Netherlands (Mss Delbressine and Goërtz, and Drs Vaes, Sillen, Janssen, and Spruit); Department of Rehabilitation, Akita City Hospital, Kawamoto Matsuoka-cho, Akita, Japan (Dr Kawagoshi); NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands (Drs Meijer and Spruit); Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands (Dr Janssen); Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands (Dr Spruit); and REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium (Dr Spruit).

Copyright

(Copyright © 2020, Lippincott Williams and Wilkins)

DOI

10.1097/HCR.0000000000000513

PMID

32355076

Abstract

PURPOSE: Chronic obstructive pulmonary disease (COPD) is a highly prevalent disease characterized by airflow limitation and is associated with decreased balance and increased fall risk. Since falls are related to increased mortality, interventions targeting balance and fall risk could reduce morbidity and mortality. The objective of this review was to systematically assess the effects of exercise-based interventions on fall risk and balance in patients with COPD.

METHODS: PubMed, Web of Science, EMBASE, and CINAHL were screened for randomized controlled trails and within-group studies evaluating effects of exercise-based interventions on fall risk or balance in patients with COPD. Data were presented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

RESULTS: Fifteen studies were identified, 6 randomized controlled trails and 9 within-group studies. All interventions reported positive effects on balance outcomes. No studies reported fall risk. Taking current recommendations of balance outcome measures in patients with COPD into account, pulmonary rehabilitation combined with balance training had the highest effect size. Nine papers had concerns regarding bias, mostly due to the lack of blinding outcome assessors.

CONCLUSIONS: Exercise-based interventions have a positive effect on balance in patients with COPD. Pulmonary rehabilitation with balance training seems to have the most beneficial effect on balance. The effects on fall risk, as well as the long-term intervention effects remain unclear. A standardized balance assessment and research on long-term effects and fall risk are recommended.

Language: en