0
Original Research: COPD |

Arm Elevation and Coordinated Breathing Strategies in Patients With COPDArm Elevation and Coordinated Breathing in COPD

Thomas E. Dolmage, MSc; Tania Janaudis-Ferreira, PhD; Kylie Hill, PhD; Shirley Price, MSc; Dina Brooks, PhD; Roger S. Goldstein, MBChB, FCCP
Author and Funding Information

From the Respiratory Diagnostic & Evaluation Services (Mr Dolmage and Dr Goldstein), Respiratory Medicine (Mr Dolmage and Drs Janaudis-Ferreira, Hill, Brooks, and Goldstein) and the Respiratory Rehabilitation Program (Ms Price and Dr Goldstein), West Park Healthcare Centre, Toronto, ON, Canada; St. John’s Rehab Research Program (Dr Janaudis-Ferreira), Sunnybrook Research Institute, Toronto, ON, Canada; Departments of Physical Therapy (Drs Janaudis-Ferreira and Brooks) and Medicine (Dr Goldstein), University of Toronto, Toronto, ON, Canada; School of Physiotherapy and Curtin Health Innovation Research Institute (Dr Hill), Curtin University, Perth, WA, Australia; and Lung Institute of Western Australia and Centre for Asthma (Dr Hill), Allergy and Respiratory Research, University of Western Australia, Perth, WA, Australia.

Correspondence to: Roger S. Goldstein, FCCP, Respiratory Medicine, West Park Healthcare Centre, 82 Buttonwood Ave, Toronto, ON, M6M 2J5, Canada; e-mail: rgoldstein@westpark.og.


Part of this article has been published in abstract form (Dolmage TE, Janaudis-Ferreira T, Hill K, et al. Arm elevation and coordinated breathing strategies in patients with severe chronic obstructive pulmonary disease (COPD). Am J Respir Crit Care Med. 2012;185:A3670).

Funding/Support: This study was funded by the Canadian Respiratory Health Professionals and supported, in part, by West Park Healthcare Centre Foundation. Dr Goldstein is supported by the National Sanitarium Association-University of Toronto Chair in Respiratory Rehabilitation Research. Dr Brooks is supported by a Canada Research Chair.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(1):128-135. doi:10.1378/chest.12-2467
Text Size: A A A
Published online

Background:  Hyperinflated patients with COPD breathe against an increased elastic load during physical activity. Arm activities are especially demanding. Some pulmonary rehabilitation programs instruct patients to inhale while raising their arms, whereas others recommend the opposite. This study aimed to determine the effect of coordinating breathing with arm movements on the endurance of a lifting task.

Methods:  Participants with COPD and hyperinflation completed two (high intensity and severe intensity) rhythmic, constant load-lifting tasks to intolerance (tlimit) before and after attending four “teaching” sessions. Participants were randomly assigned to one of three groups: (1) taught to inhale during the lift, (2) taught to exhale during the lift, or (3) sham (unconstrained coordination).

Results:  Thirty-six participants (FEV1 % predicted [SD], 34 [13]; FEV1/FVC [SD], 33% [10%]; thoracic gas volume % predicted [SD], 179 [44]) completed the study. There was an effect of group on the change in tlimit (P < .01) regardless of task intensity (P = .47). The change in tlimit in the exhalation group was greater than in both the sham (difference [95% CI]: 2.82 [0.21-5.44] min; P < .05) and inhalation (difference [95% CI]: 3.29 [0.65-5.92] min; P < .05) groups at the high intensity. There was no difference in the change in tlimit between the inhalation and sham groups.

Conclusions:  A specific breathing strategy, exhalation during the lift, improved task performance. Coordinating exhalation with lifting may be of value to hyperinflated patients with COPD who are engaged in arm and shoulder training exercises or daily activities that involve arm elevation.

Trial Registry:  ClinicalTrials.gov; No: NCT00836108; URL: www.clinicaltrials.gov

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543