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Abstract
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.