Exercise In Chronic Obstructive Pulmonary Disease Research Articles

Effects of Respiratory Muscle Activity in Stroke Patients after Feedback Breathing Exercise

and decrease involuntary respira -tion, triggering changes inrespiratory adjustment(1)and decrease inmovement of the thoracic wall and inelectric activity directly or indirectly affects pul-monary function. Therefore, respiratory efficiencyand changes inrespiratory mechanism of patientsreflect damage and asymmetry of thoracic wallmovement and muscular paralysis. In order toresolve these problems, chest wall expansion andventilation and pulmonary volume and capacityshould be appropriately maintained(2) and evaluationof functional ability of the lungs through precisemeasurement of pulmonary functions, and diagnosis,prognosis, and degree of a disease may be made toobtain the ground for exercise prescription(3). Therehave been diverse previous studies of exercises toimprove respiratory function: a study of respiratoryfunction through a long term use of positive expira -tory pressure mask and flutter treatment in cysticfibrosis patients(4), a study of respiratory muscleactivity through diaphragmatic respiration exercisein chronic obstructive pulmonary disease(COPD)patients(5), a study of abdominal muscle activitythrough respiratory muscle exercise in quadriplegiapatients(6), and a study of abdominal respiratorymuscle activation in muscle dystrophy patients(7),and a study of expiratory muscle activation throughexpiratory muscle strengthening exercise in multiplesclerosis patients(8).Thus far studies of respiratory exercise have con -cerned respiratory muscle activity, superficial respi-ratory movement largely in patients with respiratory

Current Topics in Chronic Obstructive Pulmonary Disease Exercise Programs

Current Topics in Chronic Obstructive Pulmonary Disease Exercise Programs

Factors Determining Constant Work Rate Exercise Tolerance in COPD and their Role in Dictating the Minimal Clinically Important Difference in Response to Interventions

Constant work rate exercise testing has been used to assess effectiveness of therapeutic interventions in chronic obstructive pulmonary disease. It has been noted to yield larger fractional increases in exercise tolerance than other measures. Reasons for this are rooted in physiological determinants of the time course of pulmonary ventilation. Following exercise onset, ventilation increases in three phases; the slowest phase is seen only at high exercise intensities. In chronic obstructive pulmonary disease exercise proceeds until ventilation reaches a limiting value. Because both ventilatory requirement for exercise and limiting ventilation can be manipulated by several interventions (exercise training, oxygen inhalation, bronchodilator administration), constant work rate tolerance responds to these interventions. The power-duration relationship predicts the effect of the work rate imposed on tolerated duration of a constant work rate test. Arguments are presented that a pre-intervention constant work rate duration of 4–7 minutes is desirable. At present, the recommended strategy to achieve this target duration is to choose a work rate equal to 85% of peak work rate achieved in a constant work rate test. There is clearly insufficient information to reliably determine a minimal clinically important difference for this test. A lower bound of 1.75 minutes is suggested.