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  1. McKeough, Zoe J. BAppSc (Physio)
  2. Alison, Jennifer A. Dip Phty, MSc, PhD
  3. Bye, Peter T. P. MBBS, PhD


PURPOSE:: This study aimed to compare the metabolic, ventilatory, and dyspnea responses to unsupported arm exercise, supported arm exercise and leg exercise between subjects with chronic obstructive pulmonary disease (COPD) and healthy age-matched controls.


METHODS:: For this study, 21 subjects with COPD (mean age, 62 +/- 2 years; predicted forced expiratory volume in 1 second [FEV1], 37 +/- 3%) and 7 healthy age-matched control subjects (% pred FEV1 = 109 +/- 5%) were included in the analyses of three incremental exercise tests to peak work capacity: unsupported arm exercise, supported arm exercise (arm ergometry), and leg exercise (cycle ergometry). Work level, oxygen consumption (VO2), minute ventilation (VE), dyspnea, and rate of perceived exertion were measured each minute.


RESULTS:: Peak work level and peak VO2 were significantly reduced in the subjects with COPD for all exercise tests (P < .01 for all), as compared with the control subjects. Within the COPD group, the VO2 and VE at peak exercise were significantly lower for unsupported arm exercise than for both the leg and supported arm exercises (both P < .001). The ratio of VE to maximal voluntary ventilation was high for leg exercise (96%), supported arm exercise (91%), and unsupported arm exercise (77%) among the subjects with COPD. At a given percentage of VO2 peak, dyspnea scores were similar for all the exercise tests.


CONCLUSIONS:: Ventilatory constraints limit exercise performance in COPD. The lowest amount of work, in terms of VO2,, was during unsupported arm exercise. Because the subjects with COPD had scores showing similar levels of dyspnea at the same percentage of VO2 peak, it is suggested that patients be encouraged to reach equivalent dyspnea levels when performing unsupported and supported arm exercise training and leg training.