Chest
Clinical Investigations: COPD/AsthmaThe Ventilatory Response to Arm Elevation of Patients With Chronic Obstructive Pulmonary Disease
Section snippets
Subjects
Subjects with severe but stable COPD were recruited on an ongoing basis from the hospitals Respiratory Rehabilitation Program. Informed consent was obtained from those patients who volunteered for the study. Patients selected did not require supplemental oxygen at rest or during exercise. Each subject completed Standard measurements of pulmonary function.8, 9, 10 Arterial blood gases were measured with the patient resting in the supine position and breathing room air.
Protocol
Effects of Arm Position on
Results
Pulmonary function tests measured in each of the three protocols are summarized in Table 1. Results of the baseline pulmonary function tests among these groups were similar. The patients all had severe airflow obstruction as reflected by a mean FEV1 of less than 1 L and a mean FEV1/FVC of less than 40 percent.
Effect of Arm Position on Pulmonary Function
The results of arm elevation on static lung volumes are shown in Table 2. During arm elevation there was a small but significant decrease (180
Discussion
Altered ventilatory responses have been observed during arm elevation in healthy volunteers and in subjects with COPD.1, 2, 3, 46,7 The extent to which these altered ventilatory responses are due to an increase in the metabolic demand that results from arm elevation alone remains unclear. When the arms are elevated, some muscles such as the pectorals will expand the rib cage by passive stretching, whereas others, such as serratus anterior will do so by active contraction. When expanded, the rib
Acknowledgment
The authors wish to acknowledge the assistance of D. Mills in the preparation of this manuscript.
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This work is supported by the West Park Hospital Foundation, the Ontario Rehabilitation Technology Research and Development Consortium and the Respiratory Health Network of Centres of Excellence.