Inclusion Criteria:

1. Adults with spirometry confirmed diagnosis of COPD as per GOLD guidelines (FEV1/FVC ratio below 0.7) or physician confirmed COPD diagnosis

2. Answers yes to one or more of the Three Key Questions* or Timed up and Go Test result > 11 seconds

3. An ability and capacity to provide consent to the trial

   • Q1. Have you fallen in the past year? Q2. Do you feel unsteady when standing or walking? Q3. Do you have worries about falling?

Exclusion Criteria:

1. Any neurological, musculoskeletal, chronic pain or other diagnoses that, in the opinion of the investigator, would interfere with the ability of the participant to safely complete PR and balance training
2. Unable to comprehend instruction given verbally in English language
3. Where there is concern that the primary cause of balance issues could be due to problems with visual function, vestibular disturbance or peripheral neuropathy
4. Diagnosis of, or patient-reported symptoms of, vasovagal syncope