title: Effects of a pulmonary rehabilitation program with balance training on patients with COPD.
abstract: OBJECTIVE
  Patients with chronic obstructive pulmonary disease (COPD) have balance impairments. However, pulmonary rehabilitation (PR) is associated with only minor improvements in functional balance. Therefore, there is a need to explore the role of balance training within PR. This study aimed at assessing the effects of a PR program, with a specific component of balance training, on functional balance of patients with COPD.
  
  
  METHODS
  Outpatients with COPD (N = 22, age = 68.0 ± 11.8 years; forced expiratory volume in 1 second = 72.2 ± 22.3% predicted) participated in a 12-week PR program including exercise training and psychosocial support and education. Exercise training sessions comprised endurance, strength, and a specific component of balance training. The Timed Up and Go (TUG) test was used to assess functional balance before and after the PR. Health-related quality of life (St George's Respiratory Questionnaire), quadriceps muscle strength (10 repetition maximum), and exercise tolerance (6-minute walk test) were also assessed.
  
  
  RESULTS
  Patients demonstrated significant improvements in TUG scores after PR (mean change -1.7 ± 1.4 seconds; P = .001; effect size = 1.249). Before PR, 9 (41%) participants and after PR only 1 (4.5%) participant had a TUG performance worse than the average performance of age-matched healthy peers (P = .008). The St George's Respiratory Questionnaire symptoms score (P = .012), quadriceps muscle strength (P = .001), and exercise tolerance (P = .001) were also improved.
  
  
  CONCLUSIONS
  Pulmonary rehabilitation with a specific component of balance training had a large effect on functional balance in patients with COPD. Findings highlight the value of including balance training in PR programs. Further research is needed to determine the optimal intervention to improve balance and its specific components among patients with COPD.
authors.affiliation: School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal (Drs Marques and Figueiredo, Ms Jácome, and Ms Gabriel); Unidade de Investigação e Formação sobre Adultos e Idosos (UniFAI), Porto, Portugal (Drs Marques and Figueiredo and Ms Gabriel); Department of Health Sciences (SACS), University of Aveiro, Aveiro, Portugal (Ms Cruz).
authors.forename: Alda
authors.initials: A
authors.lastname: Marques
authors.forename: Cristina
authors.initials: C
authors.lastname: Jácome
authors.forename: Joana
authors.initials: J
authors.lastname: Cruz
authors.forename: Raquel
authors.initials: R
authors.lastname: Gabriel
authors.forename: Daniela
authors.initials: D
authors.lastname: Figueiredo
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology / Q000534:rehabilitation*