Rehabilitation interventions to reduce the risk of falls in patients with chronic obstructive pulmonary disease: a systematic review of the literature

Abstract

Background: Individuals with COPD develop many clinical manifestations that affect overall morbidity and mortality, with fall risk being one of the leading factors reported in the literature. Purpose: To evaluate rehabilitation interventions aimed at reducing falls in patients with COPD.

Methods: A systematic review of literature was conducted using Pubmed, CINHAL, Scopus, Cochrane and Proquest databases by searching keywords related to chronic obstructive pulmonary disease, physical therapy interventions, fall risk and balance. Balance outcome assessments included Berg Balance Scale (BBS), Timed Up and Go (TUG), BESTest, Tinetti Performance Oriented Mobility Assessment (POMA), Activities Balance and Confidence (ABC) Scale.

Results: After identifying 1,551 citations, eight articles were included in the systematic review and demonstrated good validity based on the Evidence Based Library and Information Practice (EBL) checklist. Of the eight articles, five studies examined the impact of pulmonary rehabilitation interventions with added balance specific interventions on balance, while two additional articles examined the effects of pulmonary rehabilitation alone on balance. One of the eight articles evaluated the use of whole-body vibration training to address balance deficits. Overall, five studies reported statistically significant improvements in post-intervention scores on the TUG and BBS. One study found statistically significant differences across all functional outcome assessments between pulmonary rehabilitation and pulmonary rehabilitation with balance intervention.

Conclusion: The evidence suggests that pulmonary rehabilitation with or without balance specific interventions, may help address the underlying deficits of strength and aerobic capacity to decrease fall risk in patients with COPD.

Keywords:

• Chronic obstructive pulmonary disease
• Balance
• Pulmonary Rehabilitation
• Berg Balance scale

Disclosure statement

Jaime C. Paz; Author for Acute Care Handbook for Physical Therapists, 4th ed. Elsevier. Royalties received for textbook. No other conflict of interest noted by the authors.

Additional information

Notes on contributors

Claire Maier

Claire Maier, SPT, is a third-year doctor of physical therapy student at Walsh University. Upon graduation in April 2020, she will begin her career as a physical therapist and plans to specialize in orthopedics and manual therapy.

Jack Trabue

Jack Trabue, SPT, is a third-year doctor of physical therapy student at Walsh University. Upon graduation in April 2020, he will begin his career as a physical therapist and plans to specialize in acute care.

Katie Farley

Katie Farley, SPT, is a third-year doctor of physical therapy student at Walsh University. Upon graduation in April 2020, she will begin her career as a physical therapist and plans to specialize in neurological disorders.

Jaime Paz

Jaime Paz, PT, DPT, MS is a professor in the Doctor of Physical Therapy program at Walsh University. His teaching and research interests involve inpatient physical therapy management with focus on clinical decision making as well as physical therapy education and administration.

Alysha Walter

Alysha Walter, PT, DPT, CCS is an Assistant Clinical Professor of the Doctor of Physical Therapy program at Walsh University. She is a physical therapist with research interests in physical therapy management of cardiovascular and pulmonary disorders.