Exercise-based interventions targeting balance and falls in people with COPD: a systematic review and meta-analysis
| Title: | Exercise-based interventions targeting balance and falls in people with COPD: a systematic review and meta-analysis |
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| Authors: | Kirsti J. Loughran, Jonathan Emerson, Leah Avery, Sophie Suri, Darren Flynn, Eileen Kaner, Tim Rapley, Denis Martin, Jamie McPhee, Caroline Fernandes-James, Samantha L. Harrison |
| Source: | European Respiratory Review, Vol 33, Iss 172 (2024) |
| Publisher Information: | European Respiratory Society, 2024. |
| Publication Year: | 2024 |
| Collection: | LCC:Diseases of the respiratory system |
| Subject Terms: | Diseases of the respiratory system, RC705-779 |
| More Details: | 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. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 0905-9180 1600-0617 16000617 |
| Relation: | http://err.ersjournals.com/content/33/172/240003.full; https://doaj.org/toc/0905-9180; https://doaj.org/toc/1600-0617 |
| DOI: | 10.1183/16000617.0003-2024 |
| Access URL: | https://doaj.org/article/8090ce2b6631471b9cb1dd5a0e50b6aa |
| Accession Number: | edsdoj.8090ce2b6631471b9cb1dd5a0e50b6aa |
| Database: | Directory of Open Access Journals |
| ISSN: | 09059180 16000617 |
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| DOI: | 10.1183/16000617.0003-2024 |
| Published in: | European Respiratory Review |
| Language: | English |