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Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
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Upper limb exercise training for COPD.

Zoe J McKeough1, Marcelo Velloso, Vanessa P Lima

  • 1Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia.

The Cochrane Database of Systematic Reviews
|November 16, 2016
PubMed
Summary
This summary is machine-generated.

Upper limb exercise training offers a small improvement in dyspnea for individuals with chronic obstructive pulmonary disease (COPD) but does not enhance quality of life. Endurance training specifically boosts upper limb exercise capacity.

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Area of Science:

  • Pulmonary Rehabilitation
  • Respiratory Medicine
  • Exercise Physiology

Background:

  • Chronic obstructive pulmonary disease (COPD) frequently impairs upper limb exercise capacity due to dyspnea and arm fatigue.
  • Upper limb exercise training is a component of pulmonary rehabilitation, yet its impact on dyspnea and health-related quality of life (HRQoL) is not well-defined.

Purpose of the Study:

  • To evaluate the effects of upper limb training (endurance, resistance, or combined) on dyspnea and HRQoL in COPD patients.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) involving upper limb exercise training of at least four weeks' duration.
  • Included comparisons: upper limb training vs. no/sham intervention, combined upper/lower limb training vs. lower limb training alone, and different upper limb training types.
  • Data extracted on dyspnea, HRQoL, and upper limb exercise capacity; risk of bias assessed.

Main Results:

  • Upper limb training showed a small but significant improvement in dyspnea compared to no/sham intervention (MD 0.37).
  • No significant improvements in HRQoL were observed across comparisons.
  • Significant improvements in unsupported endurance upper limb exercise capacity were noted with upper limb training (SMD 0.66).

Conclusions:

  • Upper limb exercise training may improve dyspnea but not HRQoL in COPD patients when compared to no training or sham interventions.
  • Endurance-focused upper limb training demonstrates a notable effect on unsupported upper limb exercise capacity.
  • Further large-scale RCTs are needed to determine optimal training protocols and their effects on patient-relevant outcomes.