title: Effect of upper extremity exercise in people with COPD.
abstract: BACKGROUND
  Exercise for people with COPD has focused on leg training, such as walking and cycling. The role and effectiveness of arm training has not been investigated in detail. This review was undertaken to examine the literature for the effectiveness of upper extremity exercise on arm exercise capacity and arm strength in people with COPD.
  
  
  METHODS
  Trials relating to arm endurance and strength training in COPD were located by searching electronic databases and screening the reference lists of pertinent articles. Where possible, effect sizes and 95% CI were determined and meta-analysis used.
  
  
  RESULTS
  The search strategy yielded 24 articles. Unsupported arm training improved arm endurance capacity (standard mean difference [SMD] =1.25; 95% CI=0.16 to 2.66) and was the optimal mode of arm endurance training. Combined unsupported and supported arm training was also found to have a large positive effect on peak arm exercise capacity (SMD=1.27; 95% CI=0.59 to 1.94). In addition arm strength training produced moderate improvements in arm strength (SMD=0.46; 95% CI=0.10 to 0.81).
  
  
  CONCLUSIONS
  This review suggests that in the short term, arm endurance training improves arm exercise capacity and arm strength training improves arm strength. Further research is required, in people with COPD, to investigate the long-term effects of arm training.
authors.affiliation: School of Therapeutic sciences, Masterskill University College, Malaysia;
authors.forename: Ganesan
authors.initials: G
authors.lastname: Kathiresan
authors.forename: Senthil Kumar
authors.initials: SK
authors.lastname: Jeyaraman
authors.forename: Jayachandran
authors.initials: J
authors.lastname: Jaganathan