Feasibility of a 6-Month Home-Based Fall Prevention Exercise Program in Older Adults with COPD

Figures & data

Table 1 Demographics and Clinical Characteristics of Enrolled Participants (N=36)

Variables	N=36 Mean ± SD
Age (years)	74.4 ± 6.1
Sex, Feminine, N (%)	23 (63.8%)
BMI (Kg/m^2)	26.2 ± 9.9
Years since diagnosis	10.8 ± 7.7
Smoking history, packs (years)	45.7 ± 13.4
Number of Comorbidities	4.6 ± 2.3
Most common comorbidities, N (%)
Hypertension	21 (58.3)
Osteoarthritis	18 (50.0)
Cardiovascular disease	17 (47.2)
Depression	13 (36.1)
Osteoporosis	11 (30.6)
Diabetes	9 (25.0)
Number of Medications	9.7 ± 4.9
Most common treated conditions and medications used, N (%)
Bronchospasm (bronchodilator)	28 (77.8)
Hypertension (beta-blocker)	16 (44.4)
Airway inflammation (corticosteroid)	8 (22.2)
Diabetes (biguanide)	7 (19.4)
Depression (serotonin-norepinephrine reuptake inhibitor)	4 (11.1)
Anxiety (benzodiazepine)	4 (11.1)
Pain (opioid)	3 (8.3)
Number of exacerbations, N	22
Number of patients hospitalized, N	5
Falls history, N (%)
No	23 (63.8)
Yes	13 (36.2)
Number of falls in the past 6 months, N	16
Number of falls in the past 12 months, N	28
Worry about falling, N (%)
No	5 (13.9)
Yes	21 (58.3)
Self-reported balance problems, N (%)
No	8 (22.2)
Yes	18 (55.6)
Gait aids, N (%)
Yes	24 (68.6)
No	11 (31.4)
Supplemental Oxygen, N (%)
Yes	14 (38.9)
No	22 (61.1)
Lung Function
FEV1 (L)	1.03 ± 0.39
FEV1 (% pred)	45.03 ± 13.80
FVC (L)	2.17 ± 0.59
FVC (% pred)	78.11 ± 22.63
FEV1/FVC (%) actual	47.32 ± 14.21
6MWD (m)	319 ± 109.2

Abbreviations: BMI, body mass index; FVC, forced vital capacity; FEV₁, forced expiratory volume in 1 second; 6MWD, six-minutes walk distance, m, meters.

Figure 1 Consort flow diagram of the study.

Table 2 Comparisons of the Performance of the Participants on the Balance and Mobility Tests at Baseline, and at 3 and 6 Months (n=25)

Variables	Baseline	3-Month	6-Month	Baseline vs 3-Month	Baseline vs 6-Month	3-Month vs 6-Month
	Mean (SD)			P-value 95% CI of the Difference
BBS	49.3 (5.9)	51.5 (4.7)	51.8 (5.0)	0.008* −3.9 – −0.5	0.021* −4.6 – −0.3	0.999 −1.7–1.2
ABC	65.6 (24.1)	70.1 (18.4)	72.6 (16.0)	0.455 −12.3–3.3	0.144 −15.7–1.7	0.999 −9.3–4.2
Repeated Chair Stand	7.9 (3.2)	9.1 (3.2)	8.4 (4.2)	0.063 −2.5–0.1	0.999 −2.1–1.1	0.700 −0.8–2.3
SF-36 (PF-10)	30.6 (19.5)	36.4 (16.8)	32.0 (18.8)	0.184 −13.4–1.8	0.999 −12.3–9.5	0.721 −5.0–13.8
BESTest
Biomechanical Constraints	55.7 (19.4)	64.7 (22.7)	66.7 (20.8)	0.003* −14.7 – −3.3	0.001* −16.1 – −5.8	0.510 −8.0 – −4.0
Stability Limits/Verticality	69.3 (10.3)	77.5 (9.9)	80.6 (9.4)	0.001–12.2 – −4.2	0.001 −16.5 – −6.0	0.378 −8.0–1.9
Transitions/Anticipatory	67.1 (16.9)	75.1 (16.6)	76.2 (22.3)	0.001* −13.1 – −3.0	0.002* −13.9 – −3.0	0.999 −4.2–3.3
Reactive	62.2 (24.5)	73.5 (20.9)	85.6 (14.4)	0.012* −20.5 – −2.1	0.023* −26.4 – −1.6	0.999 −10.6–5.3
Sensory Orientation	74.4 (21.0)	77.6 (17.1)	85.6 (14.4)	0.847 −10.7–4.3	0.010* −20.0 – −2.4	0.012* −14.5 – −1.5
Stability in Gait	64.0 (18.9)	68.8 (17.0)	71.6 (19.8)	0.077 −9.9 – −0.4	0.062 −15.5–0.3	0.716 −8.9–3.2
Total Score	65.5 (12.6)	73.2 (11.9)	76.0 (12.3)	0.001* −10.9 – −4.5	0.001* −15.7 – −5.3	0.094 −6.0–0.3

Note: *Significant difference at p < 0.05.

Abbreviations: BBS, Berg Balance Scale; BESTest, Balance Evaluation Systems Test; ABC, activities-specific balance confidence; PF-10, physical function (PF-10) scale of the Medical Outcomes Study; SF-36, 36-item short form health survey.

Figure 2 Repeated measures ANOVA determined that the balance tests differed significantly between time points. Post hoc tests using Bonferroni correction revealed that home balance exercise program improved the BBS score, the BESTest total score and the scores of the subcomponent’s biomechanical constraints, stability, transitions, and reactive between baseline and 3 months and baseline and 6 months; and between baseline and 6 months, and 3 months and 6 months of exercise for the sensory subcomponent. (* = p < 0.05).