Respiratory Response and Ventilatory Muscle Recruitment During Arm Elevation in Normal Subjects

Rehabilitation and Its Concern

“…However, relatively few data exist assessing outcomes of upper extremity (UE) training compared with those available for lower extremity training. Studies have demonstrated that UE training leads to improved arm muscle endurance during isotonic arm ergometry (Ries et al, 1988) and that arm training conducted during a pulmonary rehabilitation program led to a reduced metabolic demand associated with arm exercise (Couser et al, 1992). Based on present findings, it can be concluded that strength and endurance training of the UE improves arm function and that these exercises are safe and should be included in rehabilitation programs for patients with pulmonary diseases.…”

“…It is known that even in healthy persons, arm exercise is relatively more demanding than leg exercise. Some studies have demonstrated that arm elevation is related to a disproportionate increase in the diaphragmatic contribution to the generation of ventilatory pressures (Couser et al, 1992) and that arm elevation is a fatiguing task for the muscles involved as assessed by electromyographic data Therefore, exercise training of the upper extremities may be beneficial for these patients also from the point of view that exercise training is specific to the muscles and tasks involved in the training. However, relatively few data exist assessing outcomes of upper extremity (UE) training compared with those available for lower extremity training.…”

Metabolic and ventilatory response pattern to arm elevation in patients with COPD and healthy age-matched subjects

“…In all studies, arm elevation resulted in a significant increase in metabolic and ventilatory requirements [3,4,5,8]. Possible differences in metabolic and ventilatory response pattern following arm elevation between COPD patients and healthy persons, however, have not yet been specified.…”

“…Eur Respir J., 1995Respir J., , 8, 1345Respir J., -1351 Patients with severe chronic obstructive pulmonary disease (COPD) often complain of dyspnoea during activities of daily living, such as combing their hair, brushing their teeth or shaving [1][2][3]. These activities mainly involve (unsupported) movements of arm and shoulder muscles.Several factors may contribute to impairment of unsupported arm activities in COPD patients, such as a dual activity of shoulder muscles in breathing as well as movement [4,5], and peripheral [6] and respiratory [7] skeletal muscle weakness.In order to examine the possible limitations of (unsupported) arm activities in patients with COPD, other investigators have studied the metabolic and ventilatory requirements of simple arm elevation. In all studies, arm elevation resulted in a significant increase in metabolic and ventilatory requirements [3,4,5,8].…”

Comportamento da hiperinsuflação dinâmica em teste em esteira rolante em pacientes com DPOC moderada a grave

“…(12) In this context, increased minute ventilation associated with a higher RR while walking could result in shorter expiratory time, leading to greater dynamic air trapping in comparison with that observed during cycle ergometer exercise. In addition, the movement of the arms during dynamic exercise performed in the upright position causes the intercostal inspiratory muscles to contribute less to respiratory mechanics than they do during cycle ergometer exercise because they are actively participating in the support of the arms and trunk (30) ; the abdominal muscles also aid in stabilizing the trunk, being less efficient in expiratory lung emptying (31) ; walking is associated with a less efficient gas exchange and a worsening of ventilation/perfusion mismatch, probably as a result of postural differences among lung volumes, respiratory mechanics, or lower mixed venous oxygen tension (12) ; the mechanoreceptors located in the upper limbs provide more afferent stimulation to the respiratory center (12) ; and larger muscle groups are recruited. (13) Although the present study did not directly compare walk tests and cycle ergometer exercise in terms of their ability to induce DH, a surprising finding was that one third of the patients under study showed no reduction in IC during exercise.…”