Effect of Unsupported Arm Exercise on Ventilatory Muscle Recruitment in Patients with Severe Chronic Airflow Obstruction
- 1 October 1988
- journal article
- Published by American Thoracic Society in American Review of Respiratory Disease
- Vol. 138 (4), 856-861
- https://doi.org/10.1164/ajrccm/138.4.856
Abstract
We have proposed that unsupported arm exercise alters ventilatory muscle recruitment and precipitates dyspnea in patients with severe chronic airflow obstruction (CAO). To test this hypothesis, we studied 11 patients with CAO during symptom-limited, unsupported arm exercise (UAE) and compared it with supported arm cycling (SAE). During each exercise period, we recorded endoesophageal (PpI), gastric (Pg), and transdiaphragmatic (Pdi) pressures along with heart rate, respiratory rate, and endurance time. Expired gas was collected to determine oxygen uptake (VO2) and minute ventilation (VE). Exercise endurance was shorter for UAE than for SAE (210 +/- 114 versus 270 +/- 120 s, p less than 0.05), even though peak exercise heart rate (113 +/- 5 versus 122 +/- 7 beats/min, p less than 0.05), VO2 (5.9 +/- 0.5 versus 7.1 +/- 0.8 ml/kg/min, p less than 0.05) and VE (16.5 +/- 1.2 versus 19.8 +/- 1.3 L/min, p less than 0.05) were lower for UAE. Mean (+/- SD) values for changes in pleural (delta PpI) and gastric (delta Pg) pressures during either type of arm exercise were significantly greater than at rest (p less than 0.02). In eight of 11 patients during UAE, the changes between end-inspiratory and end-expiratory transdiaphragmatic pressure (delta Pdi) were observed to develop in a similar pattern. In these patients, end-inspiratory Pg was more positive and end-inspiratory PpI was less negative during UAE than during SAE (p less than 0.02). In addition, PpI at end expiration was markedly positive when performing UAE (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)Keywords
This publication has 13 references indexed in Scilit:
- Ventilatory muscle recruitment in exercise with O2 in obstructed patients with mild hypoxemiaJournal of Applied Physiology, 1987
- Gate mechanism in breathlessness caused by chest wall vibration in humansJournal of Applied Physiology, 1984
- The Respiratory MusclesNew England Journal of Medicine, 1982
- Ventilatory responses to muscular vibrations in healthy humansJournal of Applied Physiology, 1981
- Partitioning of inspiratory pressure swings between diaphragm and intercostal/accessory musclesJournal of Applied Physiology, 1978
- Ventilatory mechanics and expiratory flow limitation during exercise in patients with obstructive lung diseaseJCI Insight, 1971
- Exercise ventilatory patterns in normal subjects and patientws with airway obstruction.Journal of Applied Physiology, 1968
- Positive work done by a previously stretched muscle.Journal of Applied Physiology, 1968
- Topography of esophageal pressure as a function of posture in manJournal of Applied Physiology, 1964
- A RAPID PLETHYSMOGRAPHIC METHOD FOR MEASURING THORACIC GAS VOLUME: A COMPARISON WITH A NITROGEN WASHOUT METHOD FOR MEASURING FUNCTIONAL RESIDUAL CAPACITY IN NORMAL SUBJECTS 1JCI Insight, 1956