title: Upper limb exercises using varied workloads and their association with dynamic hyperinflation in patients with COPD.
abstract: BACKGROUND
  Increased ventilation during upper limb exercises (ULE) in patients with COPD is associated with dynamic hyperinflation (DH) and a decrease in inspiratory capacity (IC). The best level of ULE load training is still unknown. Our objective was to evaluate the dynamic hyperinflation development during ULE using three constant workloads.
  
  
  METHODS
  This was a prospective, randomized protocol involving 24 patients with severe COPD (FEV(1) < 50%) performing an endurance symptom-limited arm exercise of up to 20 min in an arm cycloergometer with different workloads (50%, 65%, and 80% of the maximal load). Ventilation, metabolic, and lung function variables (static IC pre-exercise and postexercise) were measured.
  
  
  RESULTS
  DH was observed during exercises with 65% (-0.23 L) and 80% (-0.29 L) workloads (P < .0001). Total time of exercise with 80% workload (7.6 min) was shorter than with 50% (12.5 min) (P < .0005) and with 65% (10.1 min; not significant). Oxygen consumption percent predicted (VO(2)) (P < .01) was lower with 50% workload than with 80%. Eighty percent workload showed lower work efficiency (VO(2) [mL/kg]/exercise time) than the other two workloads (P < .0001).
  
  
  CONCLUSIONS
  Different workloads during upper limb exercises showed a direct influence over dynamic hyperinflation and the endurance exercise duration.
authors.affiliation: Pulmonary Rehabilitation Center, Universidade Federal de São Paulo/Lar Escola São Francisco, São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Colucci
authors.forename: Felipe
authors.initials: F
authors.lastname: Cortopassi
authors.forename: Elias
authors.initials: E
authors.lastname: Porto
authors.forename: Antonio
authors.initials: A
authors.lastname: Castro
authors.forename: Eduardo
authors.initials: E
authors.lastname: Colucci
authors.forename: Vinicius Carlos
authors.initials: VC
authors.lastname: Iamonti
authors.forename: Gerson
authors.initials: G
authors.lastname: Souza
authors.forename: Oliver
authors.initials: O
authors.lastname: Nascimento
authors.forename: José R
authors.initials: JR
authors.lastname: Jardim
mesh_terms: D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D014109:Total Lung Capacity / Q000502:physiology*; D034941:Upper Extremity / Q000502:physiology*