To Compare Different Respiratory Patterns on Upper Limb Exercise Capacity in Patients with COPD

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease which is characterized by persistent airflow limitation that is usually and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles and gases. Exacerbations and co-morbidities contribute to the overall severity in individual patients. OBJECTIVES: To compare different respiratory patterns on upper limb exercise capacity in patients with COPD. METHODS: Twenty two COPD patients were recruited in the study from various hospital and old age homes across Mangalore. Upper limb exercise capacity was measured in all four types of exercises two shoulder flexion-extension (one associated with inspiratory time during the concentric phase and the other associated with expiratory time) and two shoulder abduction-adduction (same timing as above). Borg's score and heart rate was noted pre and post UL exercise testing, Recovery both subjective and objective was noted post exercise testing Statistical analysis was done using Shapiro wilk test, independent t-test. Wilcoxon signed Ranked t-test, and Friedman test. RESULTS: The patient with COPD were able to perform better for longer duration with inverted breathing pattern (expiration during concentric phase of UL movement involving exercise 2 and exercise 4) when compared with the results of exercise frequently applied in clinical practice (inspiration during concentric phase of UL movement involving exercise 1 and exercise 3). There was significant difference in duration for which exercise test was performed between exercise 1 and exercise 2 with p-value of 0.002, between exercise 3 and exercise 4 with p-value <0.001. In addition among the studied exercises, exercise 4 shows significant increase in Spo2 post exercises (p-value < 0,001) with prolonged recovery 2 (objective) period for the same exercise suggesting that the gain in Spo2 was maintained for longer time as compare to other exercise. CONCLUSION: The exercises performed with inverted respiratory time (exercise 2 and exercise 4) were able to perform better than other exercise (exercise 1 and exercise 3) and can be used as important strategies during physical exercise programs in these patients