Chest
Volume 139, Issue 1, January 2011, Pages 151-158
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Original Research
Pulmonary Rehabilitation
Resistance Arm Training in Patients With COPD: A Randomized Controlled Trial

https://doi.org/10.1378/chest.10-1292Get rights and content

Background

The study aimed to evaluate the effect of upper extremity resistance training for patients with COPD on dyspnea during activity of daily living (ADL), arm function, arm exercise capacity, muscle strength, and health-related quality of life (HRQL).

Methods

Patients were randomly assigned to an intervention or control group. The intervention group underwent arm resistance training. The control group performed a sham. Both groups exercised three times a week for 6 weeks. Dyspnea during ADL and HRQL were measured using the Chronic Respiratory Disease Questionnaire (CRDQ). Arm function and exercise capacity were measured using the 6-min pegboard and ring test (6PBRT) and the unsupported upper limb exercise test (UULEX), respectively. Muscle strength for the biceps, triceps, and anterior and middle deltoids was obtained using an isometric dynamometer.

Results

Thirty-six patients with COPD (66 ± 9 years) participated in the study. Compared with the control group, the magnitude of change in the intervention group was greater for the 6PBRT (P = .03), UULEX (P = .01), elbow flexion force (P = .01), elbow extension force (P = .02), shoulder flexion force (P = .029), and shoulder abduction force (P = .01). There was no between-group difference in dyspnea during ADL, HRQL, or symptoms during the 6PBRT or UULEX (all P values > .08).

Conclusions

Resistance-based arm training improved arm function, arm exercise capacity, and muscle strength in patients with COPD. No improvement in dyspnea during ADL, HRQL, or symptoms was demonstrated.

Section snippets

Study Design

This was a prospective, double-blind, randomized controlled trial. Patients were randomly (in blocks of four) assigned to an intervention or control group. Randomization was stratified according to the presence or absence of the use of supplemental oxygen at rest. The sequence was kept in opaque envelopes by an investigator who was not involved in the recruitment process. These envelopes were drawn by the trainer after the subjects had completed their preassessment session, allowing for

Results

Thirty-six patients (33 inpatients and 3 outpatients) were recruited to participate, of whom 31 completed the posttests and were included in the analysis (Fig 1). Anthropometric, demographic, and pulmonary function data of patients included in the analysis are summarized in Table 1. No between-group differences were noted in any of the baseline characteristics. Similarly, there were no between-group differences at baseline in any of the outcome variables, except for in the shoulder flexion

Discussion

This study demonstrated that, in patients with COPD, a resistance ATP improved objective measures of arm function, arm exercise capacity, and arm muscle strength. The training program was feasible and well tolerated with good attendance.

Conclusions

This study demonstrates that a resistance-based ATP improved arm function, arm exercise capacity, and muscle strength in patients with COPD. Although no improvements in dyspnea during ADL and HRQL were demonstrated, patients achieved a superior performance during tests of arm exercise capacity, without any increase in the symptoms of dyspnea or arm fatigue after training, which reflects a positive effect on the patients' functional status. The results highlight the benefits of arm exercise

Acknowledgments

Author contributions: Dr Brooks had full access to all of the data in the study and takes full responsibility for the integrity of all of the data and the accuracy of the data analysis, including and especially any adverse effects.

Ms Janaudis-Ferreira: contributed to conceiving and designing the study, collecting the data, analyzing and interpreting the data, writing the manuscript, and approving the final version of the manuscript.

Dr Hill: contributed to conceiving and designing the study,

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    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

    Funding/Support: This study was supported by the Ontario Thoracic Society, West Park Healthcare Centre Foundation, Canada Research Chair Program, and the Swedish Heart and Lung Foundation.

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