Evidence Summary (Updated 2022)
There are a few cross-sectional and observation studies showing improved balance. Beauchamp et al found a positive correlation between physical activity and balance scores across a number of balance test measure, e.g. BBS p=0.0.007 and BESTest p=0.008.(1) An observational cohort study by Roig et al, found lower levels of physical activity as recorded by the PASE in people with COPD who experienced falls however the difference was not significant (p=0.1).(2)
A 15-study systematic review assessing the effects of exercise-based interventions on fall risk and balance was conducted.Unfortunately, no meta-analysis was performed but exercise-based interventions, such as PR +/- balance training showed beneficial effects on balance. This effect on falls risk and longer-term benefitsremains unclear..(3)
Chuatrakoon, et al conducted a narrative review of 15 cross-sectional well-conducted studies and 4 RCTs. Results showed PR + balance training/Tai Chi/Cycling exercises showed significant improvement in balance.(4)
Quality of Evidence
Grade C – low quality.
Strength of recommendation
Grade 2 – Weak recommendation.
There is some evidence although of low-grade quality that physical activity such as Tai Chi etc etc and possibly PR can improve balance and reduce the risk of falling.
- Beauchamp MK, Sibley KM, Lakhani B, Romano J, Mathur S, Goldstein RS, et al. Impairments in systems underlying control of balance in COPD. Chest [Internet]. 2012 [cited 2022 Oct 5];141(6):1496–503. Available from: https://pubmed.ncbi.nlm.nih.gov/22116798/
- Roig M, Eng JJ, MacIntyre DL, Road JD, FitzGerald JM, Burns J, et al. Falls in people with chronic obstructive pulmonary disease: an observational cohort study. Respir Med [Internet]. 2011 Mar [cited 2022 Oct 5];105(3):461–9. Available from: https://pubmed.ncbi.nlm.nih.gov/20869227/
- Delbressine JM, Vaes AW, Goërtz YM, Sillen MJ, Kawagoshi A, Meijer K, et al. Effects of Exercise-Based Interventions on Fall Risk and Balance in Patients With Chronic Obstructive Pulmonary Disease: A SYSTEMATIC REVIEW. J Cardiopulm Rehabil Prev [Internet]. 2020 May 1 [cited 2022 Oct 5];40(3):152–63. Available from: https://pubmed.ncbi.nlm.nih.gov/32355076/
- Chuatrakoon B, Ngai SPC, Sungkarat S, Uthaikhup S. Balance Impairment and Effectiveness of Exercise Intervention in Chronic Obstructive Pulmonary Disease-A Systematic Review. Arch Phys Med Rehabil [Internet]. 2020 Sep 1 [cited 2022 Oct 5];101(9):1590–602. Available from: https://pubmed.ncbi.nlm.nih.gov/32113975/