title: Asynchrony and hyperinflation in patients with chronic obstructive pulmonary disease during two types of upper limbs exercise.
abstract: BACKGROUND
  Occurrence of dynamic hyperinflation during upper-limbs exercises in chronic obstructive pulmonary disease (COPD) patients it is not well established. We hypothesized that dynamic hyperinflation and thoracoabdominal asynchrony occurs in COPD patients accomplishing arms exercises. We assessed the occurrence and association of dynamic hyperinflation and thoracoabdominal asynchrony in COPD patients during the accomplishment of two arm exercises.
  
  
  METHODS
  This was a prospective study with 25 COPD patients. A maximal and a sub-maximal upper limbs exercise test with 50% load were performed with the diagonal technique and the arm cycle ergometer technique. Respiratory pattern, thoracoabdominal configuration and dynamic hyperinflation were assessed in the exercise tests.
  
  
  RESULTS
  Thirty per cent and 60% of patients hyperinflated at the end of the sub-maximum exercise tests with the diagonal and cycle ergometer techniques, respectively. Thoracoabdominal asynchrony occurred in 80% and 100% of patients who hyperinflated with the diagonal and cycle ergometer techniques, respectively. For both exercises we found enhancement of pulmonary ventilation, dyspnea, central respiratory drive and shortening of expiratory time (P<.05). Upper-limbs exercises with the diagonal technique presented less number of patients with these alterations.
  
  
  CONCLUSIONS
  Dynamic pulmonary hyperinflation and thoracoabdominal asynchrony association occurred in both upper-limbs exercises; however, the diagonal technique developed less dynamic hyperinflation and thoracoabdominal asynchrony in COPD patients than the arm cycle ergometer.
authors.affiliation: Federal University of São Paulo (Unifesp), São Paulo, Brazil. antonioamcastro@yahoo.com.br
authors.forename: Antonio A M
authors.initials: AA
authors.lastname: Castro
authors.forename: Elias F
authors.initials: EF
authors.lastname: Porto
authors.forename: Maria I Z
authors.initials: MI
authors.lastname: Feltrim
authors.forename: José R
authors.initials: JR
authors.lastname: Jardim
mesh_terms: D000005:Abdomen / Q000503:physiopathology; D001132:Arm / Q000502:physiology*; D015992:Body Mass Index; D004417:Dyspnea / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006339:Heart Rate; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D001239:Inhalation; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000534:rehabilitation; D013147:Spirometry; D013909:Thorax / Q000503:physiopathology
chemical_list: D006454:Hemoglobins