title: Chest wall kinematics and breathlessness during unsupported arm exercise in COPD patients.
abstract: We hypothesised that chest wall displacement inappropriate to increased ventilation contributes to dyspnoea more than dynamic hyperinflation or dyssynchronous breathing during unsupported arm exercise (UAE) in COPD patients. We used optoelectronic plethysmography to evaluate operational volumes of chest wall compartments, the upper rib cage, lower rib cage and abdomen, at 80% of peak incremental exercise in 13 patients. The phase shift between the volumes of upper and lower rib cage (RC) was taken as an index of RC distortion. With UAE, no chest wall dynamic hyperinflation was found; sometimes the lower RC paradoxed inward while in other patients it was the upper RC. Phase shift did not correlate with dyspnoea (by Borg scale) at any time, and chest wall displacement was in proportion to increased ventilation. In conclusions neither chest wall dynamic hyperinflation nor dyssynchronous breathing per se were major contributors to dyspnoea. Unlike our prediction, chest wall expansion and ventilation were adequately coupled with each other.
authors: Don C. Gnocchi Foundation, Section of Respiratory Rehabilitation, Pozzolatico, Florence, Italy.
authors: Isabella
authors: I
authors: Romagnoli
authors: Francesco
authors: F
authors: Gigliotti
authors: Barbara
authors: B
authors: Lanini
authors: Giulia Innocenti
authors: GI
authors: Bruni
authors: Claudia
authors: C
authors: Coli
authors: Barbara
authors: B
authors: Binazzi
authors: Loredana
authors: L
authors: Stendardi
authors: Giorgio
authors: G
authors: Scano
mesh_terms: D000368:Aged; D001132:Arm / Q000502:physiology*; D001696:Biomechanical Phenomena / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology*; D012129:Respiratory Function Tests / Q000379:methods; D015656:Respiratory Mechanics / Q000502:physiology*; D013147:Spirometry / Q000379:methods; D035441:Thoracic Wall / Q000502:physiology*