Balance training combined with pulmonary rehabilitation improves postural balance in chronic obstructive pulmonary disease: Systematic review and meta-analysis
DOI:
https://doi.org/10.21527/2176-7114.2026.51.16946Keywords:
Pulmonary Disease, Chronic Obstructive, Postural Balance, Exercise, Rehabilitation, Meta-AnalysisAbstract
Objective: To synthesize the effects of different exercise-based therapeutic interventions on the outcomes postural balance, occurrence of falls, peripheral muscle strength and functional capacity in patients with chronic obstructive pulmonary disease (COPD). Methods: The search was carried out in the following databases: MEDLINE (PubMed), EMBASE, PEDro, CENTRAL, CINAHL, and LILACS until January 2025. Two reviewers independently performed selection, data extraction, and risk-of-bias assessment of the studies (Cochrane Handbook) and quality-of-evidence assessment (GRADE). Results: Seventeen randomized clinical trials met the eligibility criteria (n=859 patients). The addition of balance training (BT) to pulmonary rehabilitation (PR) resulted in a significant improvement in balance (MD 4.02 points; 95% CI 0.78-7.27) compared with conventional PR. The vibration platform and neuromuscular electrical stimulation (NMES) also improved balance. NMES in PR increased peripheral muscle strength (MD 36.3 N, 95% CI 15.0-57.6) and functional capacity (MD 40.91 m, 95% CI 21.17-60.65). Conclusion: This systematic review and meta-analysis suggest that therapeutic interventions such as ET, vibration platform therapy, or NMES added to PR have the potential to improve balance in COPD. Despite these promising findings, larger, low-bias studies are needed.
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Copyright (c) 2026 Tamires Daros dos Santos, Alyssia Hammel Bittencourt , Charlise Comoretto Tolfo , Dannuey Machado Cardoso , Adriane Schmidt Pasqualoto , Aron Ferreira da Silveira , Isabella Martins de Albuquerque
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