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Upper extremity exercise training in chronic obstructive pulmonary disease |
Ries AL, Ellis B, Hawkins RW |
Chest 1988 Apr;93(4):688-692 |
clinical trial |
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
Many patients with chronic obstructive pulmonary disease (COPD) report greater limitation for activities involving the upper extremities than the lower extremities. Exercise training has generally emphasized lower-extremity exercise. We designed and evaluated two simple, practical, and widely applicable upper-extremity training programs in 45 patients with COPD participating concurrently in a comprehensive, multidisciplinary pulmonary rehabilitation program. Patients were randomly assigned to one of the following three groups: (1) gravity-resistance (GR) upper-extremity training; (2) modified proprioceptive neuromuscular facilitation (PNF) upper-extremity training; or (3) no upper-extremity training (control). Patients were evaluated before and after at least six weeks of uninterrupted training. Twenty-eight patients completed the study. Compared to controls, both GR and PNF patients demonstrated improved performance on tests specific to the training performed (upper-extremity performance test, maximal level and endurance on isokinetic arm cycle). There were no significant changes on isotonic arm cycle, ventilatory muscle endurance, or simulated activities of daily-living tests. Ratings of perceived breathlessness and fatigue decreased significantly in all groups for several tests. We conclude that specific upper-extremity training may be beneficial in the rehabilitation of patients with COPD and warrants further investigation.
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