Out-Patient Pulmonary Rehabilitation Improves Medial-Lateral Balance in Subjects With Chronic Respiratory Disease: Proof-of-Concept Study.

BACKGROUND: Recent studies show balance impairment in subjects with chronic respiratory disease. The aim of this proof-of-concept study was to investigate clinical and quantitative measures of balance in people with chronic respiratory disease following participation in an out-patient pulmonary reha...

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Publicado en:Respiratory Care Vol. 61; no. 4; pp. 510 - 521
Autores principales: Smith, Michelle D., Harvey, Elizabeth H., van den Hoorn, Wolbert, Shay, Barbara L., Pereira, Gisèle M., Hodges, Paul W.
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Apr2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2016
      vid: 61
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        atl: Out-Patient Pulmonary Rehabilitation Improves Medial-Lateral Balance in Subjects With Chronic Respiratory Disease: Proof-of-Concept Study.
      aug:
        au:
          Smith, Michelle D.
          Harvey, Elizabeth H.
          van den Hoorn, Wolbert
          Shay, Barbara L.
          Pereira, Gisèle M.
          Hodges, Paul W.
        affil: School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Queensland, Australia
      sug:
        subj:
          Rehabilitation, Pulmonary
          Treatment Outcomes
          Balance, Postural
          Respiration Disorders
          Human
          Male
          Female
          Middle Age
          Aged
          Body Mass Index
          Respiratory Airflow
          Questionnaires
          Scales
          Clinical Assessment Tools
          Wilcoxon Signed Rank Test
          T-Tests
          Repeated Measures
          Data Analysis Software
          P-Value
          Post Hoc Analysis
          Muscle Strength
          Balance Training, Physical
          Accidental Falls Prevention and Control
          Chronic Disease
          Funding Source
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: BACKGROUND: Recent studies show balance impairment in subjects with chronic respiratory disease. The aim of this proof-of-concept study was to investigate clinical and quantitative measures of balance in people with chronic respiratory disease following participation in an out-patient pulmonary rehabilitation (PR) program to better understand features of balance improvement. A secondary aim was to probe possible mechanisms for balance improvement to provide the foundation for optimal design of future studies. METHODS: Eleven individuals with chronic respiratory disease enrolled in an 8-week out-patient PR program participated. Standing balance, measured with a force plate, in the medial-lateral and anterior-posterior directions with eyes open and closed was assessed with linear (SD and sway path length) and non-linear (diffusion analysis) center-of-pressure measures. Balance was evaluated clinically with the Timed Up and Go and Four Square Step Test. Fear of falling and balance confidence were assessed with questionnaires. RESULTS: After participation in PR, medial-lateral sway path length decreased (P = .031), and center-of-pressure diffusion in the medial-lateral direction was slower (P = .02) and traveled over less distance (P = .03) with eyes closed. This suggests greater control of medial-lateral sway. There was no change in anterior-posterior balance (P > .067). Performance improved on the Timed Up and Go (median [interquartile range] pre-PR = 9.4 [7.9-12.8] vs post-PR = 8.1 [7.3-12.2] s, P = .003) and Four Square Step Test (median [interquartile range] pre-PR = 9.3 [7.2-14.2] vs post-PR = 8.7 [7.4-10.2] s, P = .050). There were no changes in balance confidence (P = .72) or fear of falling (P = .57). CONCLUSIONS: Participation in an 8-week out-patient PR program improved balance, as assessed by clinical and laboratory measures. Detailed analysis of force plate measures demonstrated improvements primarily with respect to medial-lateral balance control. These data provide a basis for the development of larger scale studies to investigate the mechanisms for medial-lateral balance improvements following PR and to determine how PR may be refined to enhance balance outcomes in this population. (ClinicalTrials.gov registration NCT00864084.)
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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