Study On The Intervention Effect Of Home Pulmonary Rehabilitation Combined With Balance Training On Balance Function Of Elderly COPD Patients In The Community

Background:Patients with chronic obstructive pulmonary disease(COPD)have significantly decreased balance function compared with their peers and are associated with an increased risk of falls in this population.Pulmonary rehabilitation is the cornerstone of non-drug treatment for COPD patients,which can reduce dyspnea,exercise tolerance and activity ability of COPD patients,and can significantly improve the balance function and balance confidence of COPD patients after adding balance training.Therefore,this study investigated the intervention effect of home pulmonary rehabilitation combined with balance training on balance function in elderly COPD patients in the community.Objective:To explore the effect of 3 month home-based pulmonary rehabilitation combined with balance training intervention on balance function among COPD patients.Methods:This study was an experimental study with convenience sampling.From June to December 2019,Beijing Gaobeidian Community Health Service Center,Fangzhuang Community Health Service Center and Balizhuang Community Health Service Center were selected as the study sites.Sixty COPD patients who met the inclusion and exclusion criteria in the general practice clinic were selected and randomly divided into the control group(30 cases)and the intervention group(30 cases).The subjects in the two groups were explained and distributed with the brochure about home-based pulmonary rehabilitation and balance.The intervention group also received three months of home-based pulmonary rehabilitation combined with balance training,while the control group only received three months of home-based pulmonary rehabilitation training.Berg Balance Scale(BBS),Timed Up and Go Test(TUG),One-Leg Standing Test(OLST),Activities-Specific Balance Confidence scale(ABC)and Six-Minute Walk Test(6MWT)were used to assessment the dynamic balance,functional balance,static balance,balance confidence and exercise endurance of the two groups of study subjects before and three months after intervention to evaluate the intervention effect of home-based pulmonary rehabilitation and balance training on balance function in elderly COPD patients.Results:A total of 53 subjects completed the data collection in this study,including 27 subjects in the intervention group and 26 subjects in the control group.The study results showed that:(1)After three months of pulmonary rehabilitation combined with balance training intervention,the OLST time of the study subjects in the intervention group was 31.29(31.52)s,TUG time was 7.28(1.52)s,and ABC score was 100(3.13)points,and the OLST time of the study subjects in the control group was 22.66(34.84)s,TUG time was 8.62(2.07)s,and ABC score was 98.59(9.37)points,and the score difference was statistically significant(ZOLST=-2.678,ZTUG=3.515,P<0.01;ZABC=-2.027,P<0.05).(2)After 3 months of pulmonary rehabilitation combined with balance training intervention,the intervention group had a BBS score of 55.00(3.00)points,OLST time of 31.29(31.52)s,TUG time of 7.28(1.52)s,and ABC score of 100(3.13)points,which were significantly different from the BBS score of 52.00(1.00)points,OLST time of 28.48(54.52)s,TUG time of 8.15(1.91),and ABC score of 98.13(14.37)points before intervention(ZBBS=-3.808,ZOLST=-3.180,ZTUG=-2.971,ZABC=-3.411,P<0.01).Conclusions:Compared with home-based pulmonary rehabilitation alone,home-based pulmonary rehabilitation combined with balance training can effectively improve the functional balance,static balance and balance confidence of elderly patients with stable COPD in the community,which is an early intervention measure worthy of promotion in elderly patients with stable COPD in the community in China.