Cardiopulmonary responses during unsupported upper limb exercise tests and limitations in activities of daily living in individuals with chronic obstructive pulmonary disease

Introduction:Cardiopulmonary responses during unsupported upper limb function assessment may vary in chronic obstructive pulmonary disease (COPD).Objective: To compare the cardiopulmonary responses during the function assessment with the Six-Minute Pegboard and Ring Test (6PBRT) and the incremental Unsupported Upper Limb Exercise (UULEX) test in COPD and to investigate the correlations with muscle strength and the limitations on activity of daily living (ADLs).Methods: This was a cross-sectional study. Cardiopulmonary variables were recorded during tests using a breath-by-breath analyzer. Muscle strength was assessed using a hand-held dynamometer. Self-reported ADL was evaluated using the modified Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ-M). Paired t-test, Wilcoxon signed rank test, and Spearman correlation coefficients were used.Results: Fifteen individuals with moderate-to-severe COPD participated (66 +/- 9 years old, forced expiratory volume in the first second [FEV1]: 48%+/- 14% of predicted). The UULEX induced higher oxygen consumption (0.54 +/- 0.20 vs. 0.44 +/- 0.09 L/min, p = .01) and dyspnea (4.0 [2.6 to 6.9] vs. 0.5 [0.9 to 5.1], p < .01) than 6PBRT. The performance in both tests was correlated with self-reported ADL limitations on PFSDQ-M (6PBRT: r = -0.69, p < .01; UULEX: r = -0.62, p = .01).Conclusion: The UULEX promoted greater cardiopulmonary responses than 6PBRT, and performance in 6PBRT and UULEX was correlated with ADL limitations in individuals with COPD.