Arm Elevation and Coordinated Breathing Strategies in Patients with COPD

Background: Hyperinflated patients with COPD breathe against an increased elastic load during physical activity. Arm activities are especially demanding. Some pulmonary rehabilitation programs instruct patients to inhale while raising their arms, whereas others recommend the opposite. This study aim...

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Main Authors: Dolmage, T., Janaudis-Ferreira, T., Hill, Kylie, Price, S., Brooks, D., Goldstein, R.
Format: Journal Article
Published: American College of Chest Physicians 2013
Online Access:http://hdl.handle.net/20.500.11937/30958
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author Dolmage, T.
Janaudis-Ferreira, T.
Hill, Kylie
Price, S.
Brooks, D.
Goldstein, R.
author_facet Dolmage, T.
Janaudis-Ferreira, T.
Hill, Kylie
Price, S.
Brooks, D.
Goldstein, R.
author_sort Dolmage, T.
building Curtin Institutional Repository
collection Online Access
description Background: Hyperinflated patients with COPD breathe against an increased elastic load during physical activity. Arm activities are especially demanding. Some pulmonary rehabilitation programs instruct patients to inhale while raising their arms, whereas others recommend the opposite. This study aimed to determine the effect of coordinating breathing with arm movements on the endurance of a lifting task. Methods: Participants with COPD and hyperinflation completed two (high intensity and severe intensity) rhythmic, constant load-lifting tasks to intolerance (tlimit) before and after attending four “teaching” sessions. Participants were randomly assigned to one of three groups: (1) taught to inhale during the lift, (2) taught to exhale during the lift, or (3) sham (unconstrained coordination). Results: Thirty-six participants (FEV1 % predicted [SD], 34 [13]; FEV1/FVC [SD], 33% [10%]; thoracic gas volume % predicted [SD], 179 [44]) completed the study. There was an effect of group on the change in tlimit (P < .01) regardless of task intensity (P = .47). The change in tlimit in the exhalation group was greater than in both the sham (difference [95% CI]: 2.82 [0.21-5.44] min; P < .05) and inhalation (difference [95% CI]: 3.29 [0.65-5.92] min; P < .05) groups at the high intensity. There was no difference in the change in tlimit between the inhalation and sham groups. Conclusions: A specific breathing strategy, exhalation during the lift, improved task performance. Coordinating exhalation with lifting may be of value to hyperinflated patients with COPD who are engaged in arm and shoulder training exercises or daily activities that involve arm elevation.
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spelling curtin-20.500.11937-309582017-09-13T15:11:17Z Arm Elevation and Coordinated Breathing Strategies in Patients with COPD Dolmage, T. Janaudis-Ferreira, T. Hill, Kylie Price, S. Brooks, D. Goldstein, R. Background: Hyperinflated patients with COPD breathe against an increased elastic load during physical activity. Arm activities are especially demanding. Some pulmonary rehabilitation programs instruct patients to inhale while raising their arms, whereas others recommend the opposite. This study aimed to determine the effect of coordinating breathing with arm movements on the endurance of a lifting task. Methods: Participants with COPD and hyperinflation completed two (high intensity and severe intensity) rhythmic, constant load-lifting tasks to intolerance (tlimit) before and after attending four “teaching” sessions. Participants were randomly assigned to one of three groups: (1) taught to inhale during the lift, (2) taught to exhale during the lift, or (3) sham (unconstrained coordination). Results: Thirty-six participants (FEV1 % predicted [SD], 34 [13]; FEV1/FVC [SD], 33% [10%]; thoracic gas volume % predicted [SD], 179 [44]) completed the study. There was an effect of group on the change in tlimit (P < .01) regardless of task intensity (P = .47). The change in tlimit in the exhalation group was greater than in both the sham (difference [95% CI]: 2.82 [0.21-5.44] min; P < .05) and inhalation (difference [95% CI]: 3.29 [0.65-5.92] min; P < .05) groups at the high intensity. There was no difference in the change in tlimit between the inhalation and sham groups. Conclusions: A specific breathing strategy, exhalation during the lift, improved task performance. Coordinating exhalation with lifting may be of value to hyperinflated patients with COPD who are engaged in arm and shoulder training exercises or daily activities that involve arm elevation. 2013 Journal Article http://hdl.handle.net/20.500.11937/30958 10.1378/chest.12-2467 American College of Chest Physicians restricted
spellingShingle Dolmage, T.
Janaudis-Ferreira, T.
Hill, Kylie
Price, S.
Brooks, D.
Goldstein, R.
Arm Elevation and Coordinated Breathing Strategies in Patients with COPD
title Arm Elevation and Coordinated Breathing Strategies in Patients with COPD
title_full Arm Elevation and Coordinated Breathing Strategies in Patients with COPD
title_fullStr Arm Elevation and Coordinated Breathing Strategies in Patients with COPD
title_full_unstemmed Arm Elevation and Coordinated Breathing Strategies in Patients with COPD
title_short Arm Elevation and Coordinated Breathing Strategies in Patients with COPD
title_sort arm elevation and coordinated breathing strategies in patients with copd
url http://hdl.handle.net/20.500.11937/30958