Exercises using the upper limbs hyperinflate COPD patients more than exercises using the lower limbs at the same metabolic demand.

ABSTRACT

BACKGROUND: Lower and upper body exercise are mandatory constituents of a rehabilitation programme for patients with COPD. However, it is not known how much these exercises may induce pulmonary dynamic hyperinflation (DH). OBJECTIVE: To evaluate the DH in patients with COPD exercising the upper and lower parts of the body at the same metabolic demand. METHODS: Sixteen patients aged 63 +/- 13 years and with a FEV1 of 1.5 +/- 0.7 L (41 +/- 11% pred) were studied. Patients initially performed a maximal exercise test with the arms using the diagonal movement technique. The lower limbs were exercised on a treadmill at the same metabolic demand. RESULTS: Inspiratory capacity decreased 222 +/- 158 ml (9.8%) after the upper body exercise (p < 0.0001) and 148 +/- 161 ml (7%) after exercise with the lower body (p = 0.0028) and a difference between the two groups was found (p < 0.05). There was no difference between resting IC before upper and lower limbs exercises (p = 0.8); increase in minute ventilation and in pulmonary ventilation in percentage of maximum voluntary ventilation and reduction of expiratory time were larger in the upper limbs exercise (p < 0.05). Dyspnea as measured by the Borg Scale was higher in the upper body (3.9 +/- 2.2) than in the lower body (2.3 +/- 1.3) at the end of the exercise (p = 0.033). Pulmonary ventilation and inspiratory capacity were correlated (p = 0.0001; r = 0.82). CONCLUSION: Exercise with the upper part of the body causes more DH and dyspnea than exercise with the lower part of the body at the same metabolic demand.