Increased breathing resistance compromises the time course of rhythmical forearm movements-a pilot study

Skeletal muscle dysfunction is a major problem among the co-morbidities associated with chronic obstructive pulmonary disease (COPD). However, muscle weakness and increased fatigability are not the only limitations of skeletal muscle function. Motor-respiratory coordination (MRC) may occur even during movements at lowest workloads. MRC modifies the temporal pattern of motor actions, thus probably impairing motor performance and movement precision. Little attention has been paid to the question of whether motor functions may be compromised in COPD patients independent of workload and required muscle strength and endurance. The present pilot study was designed to investigate the effects of a simulated obstruction (SO) in healthy subjects on their breathing pattern and the timing of a rhythmical forearm movement.

Twenty-one subjects performed flexion- extension movements with their right forearm at a self-chosen rate within a range between 0.2 and 0.4 Hz. After a control experiment with normal breathing, a plug with a narrow hole was inserted between face mask and pneumotachograph to simulate obstruction. Subjects were required to repeat the rhythmical forearm movement at the same rate as in the control experiment.

The condition of SO significantly prolonged breath duration but reduced tidal volume and ventilation. In addition, period duration of the forearm movement increased significantly under this condition while the movement-to-breathing frequency ratio remained almost constant. Increased breathing resistance was considered to cause prolonged breath duration accompanied by an increase in movement period duration. The constant near-integer ratio between movement and breathing rates indicates that the change in movement period duration resulted from MRC.

The findings of this pilot study demonstrate that increased breathing resistance may compromise motor performance even at lower workloads. This means that in COPD patients, not only muscle strength and endurance are reduced but, moreover, fine motor skills may be impaired. This aspect has particular importance for many everyday activities as reduced fine motor performance substantially contributes to a progressive inability of the patients to manage their daily life.