Abstract
BACKGROUND: In Chronic Obstructive Pulmonary Disease (COPD), upper limb exercise is widely recommended. However, how the degree of shoulder flexion may influence the exercise response is unknown.
AIM: We compared metabolic, ventilatory and symptomatic responses during constant-load supported and unsupported exercise performed at 80° and 120° arm elevation.
DESIGN: Randomized cross-over study.
SETTING: Pulmonary Pathophysiology Service in an Italian Respiratory Rehabilitative Division, in-patients were enrolled.
METHODS: Twelve patients with moderate-to-severe COPD (FEV1 51%, BMI 26.7 ± 6.3 Kg/m2) performed 4 symptom-limited constant-load tests at 70% of their individual maximal workload: 2 supported and 2 unsupported, respectively at 80° and 120° of glenohumeral joint flexion, executed in a random order.
RESULTS: Time to exhaustion (Tlim), evaluated by Kaplan-Maier curve, was shorter at 120° than 80° arm elevation in both supported (360 vs.. 486 seconds, p=0.031) and unsupported exercise (210 vs.. 375 seconds, p=0.005). No difference in dynamic hyperinflation was found between 80° and 120° elevation, even at the peak of exercise and at iso-ventilation. When normalized to Tlim, 120° arm elevation had a significantly higher metabolic cost, heart rate, minute ventilation and dyspnea/fatigue symptoms compared to 80° elevation, both in unsupported and supported conditions.
CONCLUSIONS: A larger shoulder flexion shortens per se exercise endurance due to the increased metabolic, ventilatory and cardiac response, without worsening dynamic hyperinflation.
CLINICAL REHABILITATION IMPACT: Arm position should be considered when prescribing individual exercise training and may be adjusted to modulate the workload.
| Original language | English |
|---|---|
| Pages (from-to) | 690-697 |
| Number of pages | 8 |
| Journal | European Journal of Physical and Rehabilitation Medicine |
| Volume | 54 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Oct 2018 |
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Keywords
- Aged
- Arm/physiology
- Cross-Over Studies
- Dyspnea/etiology
- Exercise Therapy/methods
- Exercise Tolerance
- Female
- Humans
- Male
- Muscle Strength
- Pulmonary Disease, Chronic Obstructive/physiopathology
- Quality of Life
Cite this
The degree of arm elevation impacts the endurance and cardiopulmonary adaptations of COPD patients performing upper-limb exercise : a cross-over study. / Paneroni, Mara; Simonelli, Carla; Laveneziana, Pierantonio; Gobbo, Massimiliano; Saleri, Manuela; Bianchi, Luca; Vitacca, Michele.
In: European Journal of Physical and Rehabilitation Medicine, Vol. 54, No. 5, 10.2018, p. 690-697.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The degree of arm elevation impacts the endurance and cardiopulmonary adaptations of COPD patients performing upper-limb exercise
T2 - a cross-over study
AU - Paneroni, Mara
AU - Simonelli, Carla
AU - Laveneziana, Pierantonio
AU - Gobbo, Massimiliano
AU - Saleri, Manuela
AU - Bianchi, Luca
AU - Vitacca, Michele
PY - 2018/10
Y1 - 2018/10
N2 - BACKGROUND: In Chronic Obstructive Pulmonary Disease (COPD), upper limb exercise is widely recommended. However, how the degree of shoulder flexion may influence the exercise response is unknown.AIM: We compared metabolic, ventilatory and symptomatic responses during constant-load supported and unsupported exercise performed at 80° and 120° arm elevation.DESIGN: Randomized cross-over study.SETTING: Pulmonary Pathophysiology Service in an Italian Respiratory Rehabilitative Division, in-patients were enrolled.METHODS: Twelve patients with moderate-to-severe COPD (FEV1 51%, BMI 26.7 ± 6.3 Kg/m2) performed 4 symptom-limited constant-load tests at 70% of their individual maximal workload: 2 supported and 2 unsupported, respectively at 80° and 120° of glenohumeral joint flexion, executed in a random order.RESULTS: Time to exhaustion (Tlim), evaluated by Kaplan-Maier curve, was shorter at 120° than 80° arm elevation in both supported (360 vs.. 486 seconds, p=0.031) and unsupported exercise (210 vs.. 375 seconds, p=0.005). No difference in dynamic hyperinflation was found between 80° and 120° elevation, even at the peak of exercise and at iso-ventilation. When normalized to Tlim, 120° arm elevation had a significantly higher metabolic cost, heart rate, minute ventilation and dyspnea/fatigue symptoms compared to 80° elevation, both in unsupported and supported conditions.CONCLUSIONS: A larger shoulder flexion shortens per se exercise endurance due to the increased metabolic, ventilatory and cardiac response, without worsening dynamic hyperinflation.CLINICAL REHABILITATION IMPACT: Arm position should be considered when prescribing individual exercise training and may be adjusted to modulate the workload.
AB - BACKGROUND: In Chronic Obstructive Pulmonary Disease (COPD), upper limb exercise is widely recommended. However, how the degree of shoulder flexion may influence the exercise response is unknown.AIM: We compared metabolic, ventilatory and symptomatic responses during constant-load supported and unsupported exercise performed at 80° and 120° arm elevation.DESIGN: Randomized cross-over study.SETTING: Pulmonary Pathophysiology Service in an Italian Respiratory Rehabilitative Division, in-patients were enrolled.METHODS: Twelve patients with moderate-to-severe COPD (FEV1 51%, BMI 26.7 ± 6.3 Kg/m2) performed 4 symptom-limited constant-load tests at 70% of their individual maximal workload: 2 supported and 2 unsupported, respectively at 80° and 120° of glenohumeral joint flexion, executed in a random order.RESULTS: Time to exhaustion (Tlim), evaluated by Kaplan-Maier curve, was shorter at 120° than 80° arm elevation in both supported (360 vs.. 486 seconds, p=0.031) and unsupported exercise (210 vs.. 375 seconds, p=0.005). No difference in dynamic hyperinflation was found between 80° and 120° elevation, even at the peak of exercise and at iso-ventilation. When normalized to Tlim, 120° arm elevation had a significantly higher metabolic cost, heart rate, minute ventilation and dyspnea/fatigue symptoms compared to 80° elevation, both in unsupported and supported conditions.CONCLUSIONS: A larger shoulder flexion shortens per se exercise endurance due to the increased metabolic, ventilatory and cardiac response, without worsening dynamic hyperinflation.CLINICAL REHABILITATION IMPACT: Arm position should be considered when prescribing individual exercise training and may be adjusted to modulate the workload.
KW - Aged
KW - Arm/physiology
KW - Cross-Over Studies
KW - Dyspnea/etiology
KW - Exercise Therapy/methods
KW - Exercise Tolerance
KW - Female
KW - Humans
KW - Male
KW - Muscle Strength
KW - Pulmonary Disease, Chronic Obstructive/physiopathology
KW - Quality of Life
U2 - 10.23736/S1973-9087.18.04962-6
DO - 10.23736/S1973-9087.18.04962-6
M3 - Article
VL - 54
SP - 690
EP - 697
JO - European Journal of Physical and Rehabilitation Medicine
JF - European Journal of Physical and Rehabilitation Medicine
SN - 1973-9087
IS - 5
ER -