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    Arm Elevation and Coordinated Breathing Strategies in Patients with COPD

    Access Status
    Fulltext not available
    Authors
    Dolmage, T.
    Janaudis-Ferreira, T.
    Hill, Kylie
    Price, S.
    Brooks, D.
    Goldstein, R.
    Date
    2013
    Type
    Journal Article
    
    Metadata
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    Citation
    Dolmage, Thomas E. and Janaudis-Ferreira, Tania and Hill, Kylie and Price, Shirley and Brooks, Dina and Goldstein, Roger S. 2013. Arm Elevation and Coordinated Breathing Strategies in Patients with COPD. Chest. 144 (1): pp. 128-135.
    Source Title
    Chest
    DOI
    10.1378/chest.12-2467
    ISSN
    0012-3692
    URI
    http://hdl.handle.net/20.500.11937/30958
    Collection
    • Curtin Research Publications
    Abstract

    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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