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Updated: Dec 29, 2025
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Effects of land- and water-based exercise programmes on postural balance in individuals with COPD: additional results
Larissa A de Castro1, Josiane M Felcar1, Débora R de Carvalho1
1Research Centre in Health Sciences, University of North Parana, Londrina, Brazil; Centre of Research and Post-Graduation in Health Sciences, Londrina State University, Londrina, Brazil; Masters and Doctoral Programme in Rehabilitation Sciences, Physiotherapy Department, Londrina State University, Londrina, Brazil; University of North Parana, Londrina, Brazil; Laboratory of Research in Respiratory Physiotherapy, Physiotherapy Department, Londrina State University, Londrina, Brazil.
Objective:
To 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.
Design:
Randomised clinical trial.
Setting:
University-based, outpatient, physical therapy clinic.
Subjects:
Fifty individuals with COPD.
Interventions:
Participants 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 Measures:
Functional 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.
Results:
Seventeen 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).
Conclusion:
Functional 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 Number:
clinicalTrials.gov NCT01691131.
