Balance Training in Patients With COPD: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Abstract Introduction: Chronic Obstructive Pulmonary Disease (COPD) is characterized by various extrapulmonary alterations that limit physical and cognitive function. These alterations can impact the performance of balance training in COPD patients, given their influence on muscular aerobic capacity and exercise tolerance. Balance is crucial for mobility and quality of life, affecting patient autonomy. This research proposes a systematic review and meta-analysis to assess the effectiveness of adding balance training to Pulmonary Rehabilitation (PR) programs in COPD patients. Methodology: Registered in PROSPERO (CRD42024523748), this review covered 5 databases (PubMed, WoS, Scielo, Scopus, Pedro) up to January 2024. It included randomized clinical trials published in English, Spanish, or Portuguese, involving COPD patients over 60. The effects of a traditional PR program (aerobic, strength, flexibility, etc.) with additional balance exercises were compared to a traditional PR program. Hospitalized patient studies were excluded. Two researchers assessed article eligibility, with disagreements resolved by a third researcher. Selected documents were stored in Mendeley. A qualitative analysis examined evaluation protocols. Study quality was evaluated using the Cochrane Risk of Bias 2 (RoB 2) tool and the synthesis and quality of evidence was evaluated using Grading of Recommendation, Assessment, Development and Evaluation (GRADE). Meta-analysis was conducted using JAMOVI 5.4 software. Results: From 1167 articles, 6 randomized clinical trials assessing balance in COPD patients were selected. This included 367 individuals (72% male) aged 50 to 81 from Canada, Tunisia, India, and Thailand. Balance training protocols used unstable surfaces, dynamic and static balance, and a vibrating platform. Exercise programs were conducted for 15-30 minutes, three times a week for 2 months. COPD patients undergoing a traditional exercise program incorporating balance training showed improvement in the Timed Up and Go (TUG) compared to those receiving only a traditional exercise program (MD= 1.96; CI 95% -2.86 to -1.05, P<0.001). No differences were observed in the 6-minute walk test (MD= 1.96; CI 95% -2.86 to -1.05, P<0.001) and The Single Leg Stance Test (SLST) MD= 1.96; CI 95% -2.86 to -1.05, P<0.08). Conclusion: Adding balance exercises to a PR program is equally effective in improving aerobic capacity and strength, and significantly superior in enhancing dynamic balance in COPD patients. Additionally, interventions incorporating balance should be considered in pulmonary rehabilitation programs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.030 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.023 | 0.036 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".