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Pulmonary Rehabilitation |

Efficacy of Pulmonary Rehabilitation on Upper Limbs in COPD

Alev Gurgun, MD; Pervin Korkmaz Ekren, MD; Sami Deniz, MD; Senay Tuncel, MD; Hale Karapolat, MD; Hulya Dogan, MD; Feza Bacakoglu, MD
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Ege University Medical School Department of Chest Diseases, Izmir, Turkey


Chest. 2013;144(4_MeetingAbstracts):844A. doi:10.1378/chest.1701512
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Abstract

SESSION TITLE: Physiology/PFTs/Rehabilitation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Chronic obstructive pulmonary disease (COPD) has amajor effect on exercise capability and daily activities, which has important consequences for quality of life. Daily activities are, for an important part, performed by the arms, and patients report more dyspnea during arm than during leg exercise. his prospective randomized controlled trial was designed to evaluate the effects of PR on strength of upper limbs, functional capacity, quality of life.

METHODS: 45 stable COPD patients (42 men, mean age 65.0 ± 10.1 yrs) were admitted to PR program including upper extremity training and the control group consited of 16 stable COPD patients (16 men, 67.9±6.7 yrs) who were on usual COPD treatment. The patients in the PR group participated in an 8 week PR programme comprising exercise training in hospital twice a week and home exercises once a week. Dyspnea, quality of life, walking distance, strength of upper limbs were assessed both at baseline and after 8 weeks. Strength of upper limbs was measured with hand grip dynamometer.

RESULTS: The initial demographic characteristics were similar in both groups except body mass index and strength of upper limbs in the control group. Twenty-three (51.1%) of 45 patients had severe, 13 (28.9%) had moderate COPD. There were significant improvements in walking distance (from 260 m to 380 m), BORG dyspnea scale, in all scales of St. George’s Respiratory Questionnaire, Breathing Problems Questionnaire and three domains of Chronic Respiratory Questionnaire after PR (p<0.05). Significant increases were observed in strength of upper limbs in the PR group whereas significant reduction was found in strength of upper limbs (p<0.001, p= 0.019 respectively) in the controls. There were no improvment in any parameters in the control group.

CONCLUSIONS: Pulmonary rehabilitation improves dyspnea, exercise capacity, strength of upper limb, quality of life where upper limb strength decreases with usual treatment. Outpatient PR program including upper limb training will be a rational approach in COPD for improving daily activities.

CLINICAL IMPLICATIONS: Training of upper limbs is very important for patients with COPD who have limited daily activities. Adding upper limb exercise program to conventional pulmonary rehabilitation programs therefore will be beneficial for improving dyspnea, exercise capacity, strength of uppper limbs and quality of life.

DISCLOSURE: The following authors have nothing to disclose: Alev Gurgun, Pervin Korkmaz Ekren, Sami Deniz, Senay Tuncel, Hale Karapolat, Hulya Dogan, Feza Bacakoglu

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