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Original Research: COPD |

Upper Limb Exercises Using Varied Workloads and Their Association With Dynamic Hyperinflation in Patients With COPD

Marcelo Colucci, PT; Felipe Cortopassi, PT; Elias Porto, PT; Antonio Castro, PT; Eduardo Colucci, PT; Vinicius Carlos Iamonti, PT; Gerson Souza, PT; Oliver Nascimento, MD; José R. Jardim, MD
Author and Funding Information

From the Pulmonary Rehabilitation Center (Messrs M. Colucci, Cortopassi, Porto, Castro, E. Colucci, and Iamonti, and Ms Souza), Respiratory Division (Drs Nascimento and Jardim), Universidade Federal de São Paulo/Lar Escola São Francisco; the Physiotherapy Division of São Camilo University (Mr M. Colucci), São Paulo, Brazil; the Division of Pulmonary, Critical Care and Sleep Medicine (Mr Cortopassi), St. Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, MA; and the Physiotherapy Division of Adventist University (Messrs Porto and Castro), São Paulo, Brazil.

Correspondence to: José R. Jardim, MD, Rua Botucatu, 740 - 3o floor Respiratory Division (Pneumologia/Unifesp) 04023-062, São Paulo, Brazil; e-mail: joserjardim@yahoo.com.br


Funding/Support: This study was funded in part by CAPES, CNPq, and FAPESP, Brazil.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(1):39-46. doi:10.1378/chest.09-2878
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Background:  Increased ventilation during upper limb exercises (ULE) in patients with COPD is associated with dynamic hyperinflation (DH) and a decrease in inspiratory capacity (IC). The best level of ULE load training is still unknown. Our objective was to evaluate the dynamic hyperinflation development during ULE using three constant workloads.

Methods:  This was a prospective, randomized protocol involving 24 patients with severe COPD (FEV1 < 50%) performing an endurance symptom-limited arm exercise of up to 20 min in an arm cycloergometer with different workloads (50%, 65%, and 80% of the maximal load). Ventilation, metabolic, and lung function variables (static IC pre-exercise and postexercise) were measured.

Results:  DH was observed during exercises with 65% (−0.23 L) and 80% (−0.29 L) workloads (P < .0001). Total time of exercise with 80% workload (7.6 min) was shorter than with 50% (12.5 min) (P < .0005) and with 65% (10.1 min; not significant). Oxygen consumption percent predicted (V˙ o2) (P < .01) was lower with 50% workload than with 80%. Eighty percent workload showed lower work efficiency (V˙ o2 [mL/kg]/exercise time) than the other two workloads (P < .0001).

Conclusion:  Different workloads during upper limb exercises showed a direct influence over dynamic hyperinflation and the endurance exercise duration.

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