Evaluation of effects of shoulder girdle training on strength and performance of activities of daily living in patients with chronic obstructive pulmonary disease

Marcelo Velloso, Nilce Helena do Nascimento, Mariana R Gazzotti, Jos&eacute; R Jardim Pulmonary Rehabilitation Center, Federal University of S&atilde;o Paulo/Associa&ccedil;&atilde;o de Assist&ecirc;ncia &agrave; Crian&ccedil;a Deficiente (Unifesp/AACD), Brazil Background: Patients with chronic obstructive pulmonary disease (COPD) have some limitations during activities of daily living that involve the arms. There is little information on the benefits of shoulder girdle training and its repercussions for activities of daily living in patients with COPD. The purpose of this study was to investigate whether shoulder girdle training with diagonal movements increases upper limb muscle strength and improves performance of activities of daily living in patients with COPD. Methods: Thirty-five patients with moderate to severe COPD (forced expiratory volume in one second 1.22 &plusmn; 0.49 L) and aged 36&ndash;80 years were recruited. Endurance time, maximal sustained weight, oxygen saturation, heart rate, respiratory rate, dyspnea, and arm fatigue were evaluated during an incremental upper limb test and eight simulated activities of daily living before and after an 8-week exercise training program. Results: A significant gain was observed for upper limb strength (P < 0.05). At the peak of the upper limb incremental test, the respiratory rate dropped from 33 to 27 breaths per minute, the Borg dyspnea score decreased from 2 to 0.5, and the upper limb fatigue score decreased from 3 to 2 (P < 0.05). No change was seen in any of these parameters during performance of activities of daily living. Conclusion: Although shoulder girdle training increased upper limb strength, no improvement was detected in performance of activities of daily living. Keywords: pulmonary disease, rehabilitation, upper limb trainin