title: Upper extremity exercise training in chronic obstructive pulmonary disease.
abstract: Many patients with chronic obstructive pulmonary disease (COPD) report greater limitation for activities involving the upper extremities than the lower extremities. Exercise training has generally emphasized lower-extremity exercise. We designed and evaluated two simple, practical, and widely applicable upper-extremity training programs in 45 patients with COPD participating concurrently in a comprehensive, multidisciplinary pulmonary rehabilitation program. Patients were randomly assigned to one of the following three groups: (1) gravity-resistance (GR) upper-extremity training; (2) modified proprioceptive neuromuscular facilitation (PNF) upper-extremity training; or (3) no upper-extremity training (control). Patients were evaluated before and after at least six weeks of uninterrupted training. Twenty-eight patients completed the study. Compared to controls, both GR and PNF patients demonstrated improved performance on tests specific to the training performed (upper-extremity performance test, maximal level and endurance on isokinetic arm cycle). There were no significant changes on isotonic arm cycle, ventilatory muscle endurance, or simulated activities of daily-living tests. Ratings of perceived breathlessness and fatigue decreased significantly in all groups for several tests. We conclude that specific upper-extremity training may be beneficial in the rehabilitation of patients with COPD and warrants further investigation.
authors.affiliation: Department of Medicine, University of California, San Diego.
authors.forename: A L
authors.initials: AL
authors.lastname: Ries
authors.forename: B
authors.initials: B
authors.lastname: Ellis
authors.forename: R W
authors.initials: RW
authors.lastname: Hawkins
mesh_terms: D000203:Activities of Daily Living; D001132:Arm / Q000502:physiology*; D005080:Exercise Test; D005081:Exercise Therapy; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000534:rehabilitation*; D009119:Muscle Contraction; D005082:Physical Exertion; D011897:Random Allocation; D012129:Respiratory Function Tests