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Lookup NU author(s): Dr Leah Avery, Dr Darren Flynn, Professor Eileen KanerORCiD, Professor Tim Rapley, Stephanie Harrison
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
Copyright © The authors 2024. INTRODUCTION: This review quantifies the mean treatment effect of exercise-based interventions on balance and falls risk in people with COPD. METHODS: A structured search strategy (2000-2023) was applied to eight databases to identify studies evaluating the impact of exercise-based interventions (≥14 days in duration) on balance or falls in people with COPD. Pooled mean treatment effects (95% confidence intervals (CIs), 95% prediction intervals (PIs)) were calculated for outcomes reported in five or more studies. Inter-individual response variance and the promise of behaviour change techniques (BCTs) were explored. RESULTS: 34 studies (n=1712) were included. There were greater improvements in balance post intervention compared to controls for the Berg Balance Scale (BBS) (mean 2.51, 95% CI 0.22-4.80, 95% PI -4.60-9.63), Timed Up and Go (TUG) test (mean -1.12 s, 95% CI -1.69- -0.55 s, 95% PI -2.78-0.54 s), Single-Leg Stance (SLS) test (mean 3.25 s, 95% CI 2.72-3.77 s, 95% PI 2.64-3.86 s) and Activities-specific Balance Confidence (ABC) scale (mean 8.50%, 95% CI 2.41-14.58%, 95% PI -8.92-25.92%). Effect on falls remains unknown. Treatment effects were larger in male versus mixed-sex groups for the ABC scale and SLS test, and in balance training versus other exercise-based interventions for the BBS and TUG test. Falls history was not associated with changes in balance. Meta-analysis of individual response variance was not possible and study-level results were inconclusive. Eleven promising BCTs were identified (promise ratio ≥2). CONCLUSION: Evidence for the effect of exercise-based interventions eliciting clinically important improvements in balance for people with COPD is weak, but targeted balance training produces the greatest benefits. Future exercise interventions may benefit from inclusion of the identified promising BCTs.
Author(s): Loughran KJ, Emerson J, Avery L, Suri S, Flynn D, Kaner E, Rapley T, Martin D, McPhee J, Fernandes-James C, Harrison SL
Publication type: Article
Publication status: Published
Journal: European Respiratory Review
Year: 2024
Volume: 33
Issue: 172
Online publication date: 26/06/2024
Acceptance date: 19/03/2024
Date deposited: 15/07/2024
ISSN (print): 0905-9180
ISSN (electronic): 1600-0617
Publisher: European Respiratory Society
URL: https://doi.org/10.1183/16000617.0003-2024
DOI: 10.1183/16000617.0003-2024
PubMed id: 38925795
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