Pulmonary rehabilitation: upper-limb exercise training in patients with COPD; a literature review

Abstract

Pulmonary rehabilitation (PR) has received large attention in the treatment of patients with chronic obstructive pulmonary diseases (COPD),
with the aim of minimizing symptoms, improving physical tolerance and
increasing quality of life. As a huge number of programs are created, concern in standardizing them arises, as well as the need to better understanding the techniques and methods of protocols used. The aim of the present study is to sum up literature guidelines in upper-limb training in COPD patients. Following the bibliography survey, review and comparative articles on the subject were analyzed. In a PR program, the upper-limb training aims at increasing exercise performance, reducing ventilatory demand during upperlimb work and increasing endurance to the exercise. There is no common consensus on the best way to train upper-limbs. The most commonly used method is upper-limb training without support, as it offers more advantages for it resembles daily-life activities. The need to further research remains, in order to establish a better selection criteria of patients who may potentially benefit from the training, as well as to obtain physical therapists commitment, in a multidisciplinary staff, to assess diverse upper-limb training programs, including the assessment of effects onto the type, duration, frequency, and intensity of the program.