Home Balance Pilot for Fall Reduction in COPD

Chronic obstructive pulmonary disease (COPD) is highly prevalent among older adults and is a leading cause of death, disability and hospitalization in Canada. There is a growing body of evidence demonstrating that older adults with COPD have important problems with their balance and a high incidence of falls compared to those of a similar age. This research will explore the feasibility and preliminary efficacy of a tailored 6-month home balance exercise program for reducing falls in older adults with COPD.

The primary objective of this pilot study is to determine the feasibility of a tailored home balance intervention for older adults with COPD in terms of recruitment, retention and adherence. The secondary objective is to examine the within-subject effects of the home-balance intervention on intermediate outcomes linked to falls including balance, functional strength and self-reported disability.

Thirty-five older adults with COPD will be recruited from respirology clinics at West Park Healthcare Centre (Toronto) and the Firestone Institute for Respiratory Health (Hamilton) to participate in a single-group, non-randomized clinical trial. Eligible participants will be enrolled in a 6-month balance home exercise intervention. The home program will be supervised by a physiotherapist and outcome measures will be collected at home at baseline, 3- and 6-months by a research assistant not involved in the intervention.

Inclusion criteria

• a clinical diagnosis of COPD;
• age ≥ 60 yrs;
• a history of 1 or more falls in the previous year;
• ability to provide written informed consent.

Exclusion criteria

• inability to communicate in English;
• history of significant cardiovascular disease;
• marked decrease in arterial oxygen saturation at rest or during previous assessments of exercise capacity;
• severe cognitive impairment;
• evidence of a condition that severely limits mobility and may jeopardize safety;
• completion of a course of rehabilitation in the last 6 months or on a wait list for admission to rehabilitation.