title: Home-based, upper-arm exercise training for patients with chronic obstructive pulmonary disease.
abstract: Prior studies demonstrate the ability of upper extremity training to increase arm strength and endurance when incorporated into a pulmonary rehabilitation program. However, patients with severe chronic obstructive pulmonary disease (COPD) may have transportation or mobility problems that make it difficult to travel to a rehabilitation site to obtain this training. This pilot study was designed to determine whether a home-based, upper-arm exercise program could increase arm strength and endurance, and decrease perceptions of breathlessness and fatigue during five activities of daily living. Twenty patients with severe COPD (FEV1 0.80 +/- 0.42) were randomized to an experimental (n = 10) or control group (n = 10). The experimental-group training included three upper arm exercises five times a week for 8 weeks, with training level incremented during weekly home visits. Control-group subjects were contacted weekly to equalize attention from health care providers. During the upper-extremity endurance test for number of rings moved, no significant differences between groups were seen for interaction or treatment. However, there was a significant interaction between treatment and time for perceived fatigue (p = 0.0012), with the experimental group perceiving less fatigue during upper arm work than did the control group. No change was seen in perceived breathlessness. Findings of this study suggest that a home-based, upper-arm exercise program can reduce perceptions of fatigue for patients with severe COPD during activities involving upper arm work. Testing in a larger sample is indicated to determine whether this training can also improve ability to perform unsupported arm work.
authors.affiliation: Division of Cardiothoracic Surgery, University of Pittsburgh Medical Center, PA 15213, USA.
authors.forename: G S
authors.initials: GS
authors.lastname: Bauldoff
authors.forename: L A
authors.initials: LA
authors.lastname: Hoffman
authors.forename: F
authors.initials: F
authors.lastname: Sciurba
authors.forename: T G
authors.initials: TG
authors.lastname: Zullo
mesh_terms: D001132:Arm; D005081:Exercise Therapy; D005221:Fatigue; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects