scholarly journals Arm exercise training in chronic obstructive pulmonary disease

2012 ◽  
Vol 9 (3) ◽  
pp. 153-162 ◽  
Author(s):  
Zoe J McKeough ◽  
Peter TP Bye ◽  
Jennifer A Alison

The aim of this study was to compare the effects of arm endurance training, arm strength training, a combination of arm endurance and strength training, and no arm training on endurance arm exercise capacity. A randomised controlled trial was undertaken with chronic obstructive pulmonary disease subjects randomised into one of four groups to complete 8 weeks of training: (a) arm endurance training (endurance group) consisting of supported and unsupported arm exercises, (b) arm strength training (strength group) using weight machines, (c) a combination of arm endurance and arm strength training (combined group), or (d) no arm training (control group). The primary outcome measurement was endurance arm exercise capacity measured by an endurance arm crank test. Secondary outcomes included functional arm exercise capacity measured by the incremental unsupported arm exercise test and health-related quality of life. A total of 52 subjects were recruited and 38 (73%) completed the study. When comparing the arm endurance group to the control group, there was a significant increase in endurance time of 6 min (95% CI 2–10, p < 0.01) following the interventions. When comparing the combined group to each of the control, endurance and strength groups, there was a significantly greater reduction in dyspnoea and rate of perceived exertion at the end of the functional arm exercise test for the combined group following the interventions. The mode of training to be favoured to increase endurance arm exercise capacity is arm endurance training. However, combined arm endurance and strength training may also be very useful to reduce the symptoms during everyday arm tasks.

Author(s):  
PENG AN ◽  
PING QIN ◽  
JIANRU WANG ◽  
HE RONG ZHOU

Objective: To study the correlation between diaphragm excursion and both the quality of life and exercise capacity in patients with chronic obstructive pulmonary disease (COPD) by ultrasound and to reveal the factors affecting diaphragm excursion. Methods: A total of 42 COPD patients who were treated in our hospital from October 2015 to March 2020 and 42 healthy volunteers (control group) were included in the present study. The participants’ height, weight, and diaphragm excursion (the amplitude of diaphragm movement during deep breathing measured by M-mode ultrasound ([Formula: see text])), diaphragm movement time, degree of airflow obstruction (the forced expiratory volume in one second (FEV1) as a percentage of its predicted level, FEV1%pred), and exercise capacity (six-minute walk distance, 6MWD) were measured. The St. George’s Respiratory Questionnaire (SGRQ) was used to evaluate the patients’ quality of life. The correlation between the amplitude of diaphragm movement and lung function was analyzed. The receiver operating characteristics (ROC) curve was used to determine the COPD diagnosis efficacy of M-mode ultrasound, and its influencing factors were further analyzed. Results: During tidal breathing, the movement amplitudes of both hemidiaphragms in the COPD group were greater than those in the control group. During deep breathing, the movement amplitudes of both hemidiaphragms in the control group were greater than those in the COPD group. Moreover, during both tidal and deep breathing, the movement time of the right hemidiaphragm in the control group was longer than that in the COPD group (all [Formula: see text]). During deep breathing, the amplitude of diaphragm movement was positively correlated with FEV1 and FEV1%pred (both [Formula: see text]). During both tidal and deep breathing, the area under the ROC curve (AUC) for the diagnosis of COPD according to the diaphragm movement amplitude was 0.833 and 0.887, respectively, and the AUC for the diagnosis of COPD according to the diaphragm movement time was 0.625 and 0.732, respectively. The [Formula: see text] was correlated with the SGRQ score, symptom score, impact score, activity score, and 6MWD, with correlation coefficients of [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], and 0.536, respectively. The factors affecting the [Formula: see text] were height ([Formula: see text], [Formula: see text]) and FEV1%pred ([Formula: see text], [Formula: see text]). Conclusion: The diaphragm excursion in COPD was closely related to patients’ quality of life. Height and FEV1%pred had the greatest impact on diaphragm excursion. The lower the diaphragm excursion of the patient, the worse their quality of life and the lower their exercise capacity.


2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.


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