Effect of Proprioceptive Training with Muscle Strengthening on Postural Instability in Patients with Chronic Obstructive Pulmonary Disease

Document Type : Original Article


The Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy*, Cairo University and Chest Department, Faculty of Medicine, Menoufia University**


Abstract Background: Chronic obstructive pulmonary disease (COPD) is preventableand treatablelung disease characterized by narrowing airways and inflammation. However, it is ac-companied by several extrapulmonary problems as balance problems and decrease in postural control combined with muscle weakness and proprioception deficits. Aim of Study: Todetermine the effect of proprioceptive training with muscle strengthening on postural instability in patients with COPD. Patients and Methods: Sixty COPD male patients with postural balance problems their age ranged between 55 to 65 years were randomly chosen and assigned into study and control groups. Both the groups practiced pulmonary rehabil-itation program with medications, study group in addition to pulmonary rehabilitation applied proprioceptive training with muscle strengthening exercises for 12 weeks. Balance was evaluated by using Berg Balance Scale (BBS) and Activities-specific Balance Confidence Scale (ABC), and muscle strength was assessed using handheld dynamometer. Results: At the end of the study, there were a significant increase in BBS, ABC, quadriceps and calf muscles' strength scale in both groups post treatment compared with that pre-treatment. The percent of change of BBS, ABC scale, right and left quadriceps strength and right and left calf muscle strength in the study group was (28.77, 29.69%, 15.53, 15.21, 26.77 and 27.74%) respectively, and (5.61, 4.2%, 0.36 and 1.63%)respectively for control group, there was no significant change in calf muscle strength in the control group (p<0.05). In comparison between groups there was significantincrease in BBS, ABC, quadricepsand calf muscles' strength in the study group more than the control group (p>0.001). Conclusion: It was concluded that adding proprioceptive training with muscle strengthening exercises to pulmonary rehabilitation program was more effective in improving postural balance control inpatients with COPD.