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

Abstract

ObjectiveTo 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. DesignRandomised clinical trial. SettingUniversity-based, outpatient, physical therapy clinic. SubjectsFifty individuals with COPD. InterventionsParticipants 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. Main outcome measuresFunctional 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. ResultsSeventeen 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<0.001). ConclusionFunctional balance improved after 3months of high-intensity exercise training performed in water. Despite the environment, non-specific training seems to be insufficient to improve static balance. Clinical trial registration numberclinicalTrials.gov NCT01691131.