Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Cambridge, MA; Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, St. John's Rehab Program, Toronto, ON, Canada; Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
Chest. 2013 Dec;144(6):1803-1810. doi: 10.1378/chest.13-1093.
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).
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.
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).
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.
在 COPD 中,平衡缺陷越来越被认为是重要的次要障碍之一。本研究旨在探讨平衡训练计划对接受肺康复(PR)的 COPD 患者平衡和身体功能测量的影响。
患者被随机分配到干预组或对照组。干预组在进行 6 周 PR 的同时每周进行 3 次平衡训练。对照组仅接受 6 周 PR 计划。临床平衡测量包括 Berg 平衡量表(BBS)、平衡评估系统测试(BESTest)和活动特异性平衡信心量表(ABC 量表)。36 项简短健康调查问卷(SF-36)的身体功能子量表和 30 秒椅站测试分别用于测量自我报告的身体功能和下肢肌肉力量。
39 名 COPD 患者(平均 FEV1,37.5%±15.6%预测值)参与了研究。平衡训练计划的平均依从率为 82.5%,未报告不良事件。与对照组相比,干预组 BBS(P<.01)、BESTest(P<.01)、PF-10(P=.01)和 30 秒椅站(P=.02)得分显著提高。干预组和对照组在 ABC 量表的变化得分上没有显著差异(P=.2)。
我们的结果支持将平衡训练作为 PR 的一部分的可行性和有效性,可改善中重度 COPD 患者的平衡表现、肌肉力量和自我报告的身体功能。