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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Pulmonary Medicine 1/2015

Minimizing the evidence-practice gap – a prospective cohort study incorporating balance training into pulmonary rehabilitation for individuals with chronic obstructive pulmonary disease

BMC Pulmonary Medicine > Ausgabe 1/2015
Samantha L. Harrison, Marla K. Beauchamp, Kathryn Sibley, Tamara Araujo, Julia Romano, Roger S. Goldstein, Dina Brooks
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12890-015-0067-2) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare they have no competing interests.

Authors’ contributions

SH contributed to conceiving and designing the study, data collection, interpreting the data, writing the manuscript, and approving the final version of the manuscript. MB and KS contributed to interpreting the data, providing critical revisions that are important for the intellectual content, and approving the final version of the manuscript. JR and TA contributed to data collection, providing critical revisions that are important for the intellectual content, and approving the final version of the manuscript. RG and DB contributed to conceiving and designing the study, interpreting the data, providing critical revisions that are important for the intellectual content, and approving the final version of the manuscript.



We have recently demonstrated the efficacy of balance training in addition to Pulmonary Rehabilitation (PR) at improving measures of balance associated with an increased risk of falls in individuals with Chronic Obstructive Pulmonary Disease (COPD). Few knowledge translation (KT) projects have been conducted in rehabilitation settings. The goal of this study was to translate lessons learnt from efficacy studies of balance training into a sustainable clinical service.


Health care professionals (HCPs) responsible for delivering PR were given an hour of instruction on the principles and practical application of balance training and the researchers offered advice regarding; prescription, progression and practical demonstrations during the first week. Balance training was incorporated three times a week into conventional PR programs. Following the program, HCPs participated in a focus group exploring their experiences of delivering balance training alongside PR. Service users completed satisfaction surveys as well as standardized measures of balance control. At six month follow-up, the sustainability of balance training was explored.


HCPs considered the training to be effective at improving balance and the support provided by the researchers was viewed as helpful. HCPs identified a number of strategies to facilitate balance training within PR, including; training twice a week, incorporating an interval training program for everyone enrolled in PR, providing visual aids to training and promoting independence by; providing a set program, considering the environment and initiating a home-based exercise program early. Nineteen service users completed the balance training [ten male mean (SD) age 73 (6) y]. Sixteen patients (84 %) enjoyed balance training and reported that it helped them with everyday activities and 18 (95 %) indicated their wish to continue with it. Scores on balance measures improved following PR that included balance training (all p < 0.05). At six month follow-up balance training is being routinely assessed and delivered as part of standardised PR.


Implementing balance training into PR programs, with support and training for HCPs, is feasible, effective and sustainable.

Trail registration

Clinical Trials ID: NCT02080442 (05/03/2014)
Additional file 1: Table outlining the KT actions and subsequent effect.
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