Effects of land- and water-based exercise programmes on postural balance in individuals with COPD: additional results from a randomised clinical trial

• Published in: Physiotherapy 2020-06, Vol.107 (NA), p.58-65
• Main Authors: de Castro, Larissa A., Felcar, Josiane M., de Carvalho, Débora R., Vidotto, Laís S., da Silva, Rubens A., Pitta, Fabio, Probst, Vanessa S.
• Format: Article
• Language: English
• Subjects: Accidental falls; Accidental Falls - prevention & control; Aged; Chronic; Endurance Training - methods; Exercise therapy; Exercise Therapy - methods; Female; Humans; Hydrotherapy; Male; Middle Aged; Obstructive pulmonary disease; Postural Balance; Pulmonary Disease, Chronic Obstructive - rehabilitation; Resistance Training - methods; Walk Test; Water
• ISSN: 0031-9406; 1873-1465
• DOI: 10.1016/j.physio.2019.08.001

To investigate the effects of water-based exercise training on postural balance in individuals with chronic obstructive pulmonary disease (COPD), and compare the effects of two similar protocols of land- and water-based exercise programmes on postural balance in this population. Randomised clinical trial. University-based, outpatient, physical therapy clinic. Fifty individuals with COPD. Participants were assigned at random to the land group (LG; n=27) or the water group (WG; n=23), and underwent high-intensity endurance and strength training three times per week for 3months. Functional balance was assessed by the timed up and go test (TUG), and static balance was assessed with a force platform in the following conditions: standing with feet hip-width apart and eyes open; standing with feet hip-width apart and eyes closed; standing on a short base; and one-legged stance. Seventeen subjects completed the intervention in the LG {nine males, mean age 64 [standard deviation (SD) 8] years, mean forced expiratory volume in 1 second (FEV1) 48 (SD 17) %predicted} compared with 14 subjects in the WG [nine males, mean age 65 (SD 8) years, FEV1 51 (SD 15) %predicted]. Water-based exercise training had a positive effect on functional balance [TUG: mean difference −1.17 (−1.93 to −0.41 95% confidence interval) seconds; P=0.006], whereas static balance remained unaltered for both groups. There was no between-group difference in postural balance after exercise training; however, a higher proportion of participants who had a clinically relevant improvement in the TUG were in the WG (LG 35%, WG 64%; P