Does adding balance training to pulmonary rehabilitation help older COPD patients improve their balance?
Balance problems are common in people with COPD and can increase fall risk. Standard pulmonary rehabilitation (PR) focuses on breathing and exercise, but often does not include specific balance exercises. A 2024 meta-analysis looked at whether adding balance training to PR helps older COPD patients improve their balance. The answer is yes: adding balance training leads to meaningful improvements in static balance, dynamic balance, overall balance, and balance confidence.
What the research says
A 2024 systematic review and meta-analysis pooled data from 7 randomized controlled trials involving 548 COPD patients aged 50 years and older 1. The studies compared standard pulmonary rehabilitation (PR) alone with PR plus specific balance training (BT). The balance training included static and dynamic exercises, dual-task activities (doing two things at once), and progression from stable to unstable surfaces 1.
Results showed that adding BT significantly improved static balance (by about 3.3 seconds on a standing test), dynamic balance (by about 2.1 seconds faster on a walking test), overall balance (by about 3 points on a balance scale), and balance confidence (by about 6.5 points on a confidence scale) 1. Health-related quality of life also improved more with PR+BT than with PR alone 1.
Another study found that patients with severe COPD have significantly worse balance and dual-task performance compared to healthy adults, highlighting the need for balance training in this group 10. A separate review on exercise in older adults noted that targeted exercise programs can help counteract balance impairment and reduce fall risk 9.
While the evidence is strong that balance training helps, the meta-analysis noted that the included trials were relatively small and used different balance exercises, so the best type or dose of balance training is not yet clear 1.
What to ask your doctor
- Does my current pulmonary rehabilitation program include any balance exercises?
- Would adding specific balance training be safe and helpful for me?
- What types of balance exercises would you recommend for someone with my COPD severity?
- How often and for how long should I do balance training to see improvement?
- Are there any fall risk assessments or balance tests I should have?
This question is drawn from common patient questions about Pulmonology & Critical Care and answered using cited medical research. We do not provide individualized advice.