OBJECTIVE: Exercise training in people with chronic obstructive pulmonary disease (COPD) is widely accepted as the cornerstone to pulmonary rehabilitation. Traditionally, exercise for people with COPD has focused on leg training, such as walking and cycling. However, the recognition that there is greater limitation for daily arm activities has attracted interest in the effectiveness of arm training. This review was undertaken to examine the literature for the effectiveness of arm endurance and strength training on arm exercise capacity in people with COPD. METHODS: Trials relating to arm endurance and strength training in COPD were located by searching electronic databases and screening the reference lists of pertinent articles. Where possible, effect sizes and 95% CI were determined and meta-analysis used. RESULTS: The search strategy yielded 24 articles. Unsupported arm training improved arm endurance capacity (standard mean difference (SMD) 1.25; 95% CI -0.16 to 2.66) and was the optimal mode of arm endurance training. Combined unsupported and supported arm training was also found to have a large positive effect on peak arm exercise capacity (SMD 1.27; 95% CI 0.59 to 1.94). In addition arm strength training produced moderate improvements in arm strength (SMD 0.46; 95% CI 0.10 to 0.81). CONCLUSION: This review suggests that in the short term, arm endurance training improves arm exercise capacity and arm strength training improves arm strength. Further research is required, in people with COPD, to investigate the long-term effects of arm training and to determine the optimal training routine for improving arm tasks important for daily living.

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A brief summary and a critical assessment of this review may be available at DARE