Hemodynamic and respiratory responses to maximal treadmill and arm ergometry exercise in men with chronic obstructive pulmonary disease

Arm exercise training has been advocated for patients with chronic obstructive pulmonary disease (COPD) to improve functional capacity. However, little clinical experience regarding the value of this form of exercise training or comparison of the physiologic differences between leg and arm exercise in patients with COPD has been reported. The authors compared hemodynamic and respiratory responses during maximal treadmill and arm ergometry exercise in 24 men with COPD. Heart rate, systolic blood pressure, minute ventilation (V(E)). Respiratory exchange ratio (RER), carbon dioxide production (VCO₂), oxygen saturation, and oxygen pulse were similar at peak levels of leg and arm exercise. Peak oxygen consumption (VO₂) was significantly higher during maximal leg exercise (1.03 ± 0.39 vs 0.87 ± 0.29 L/min, P < 0.01). Conversely, peak ventilatory equivalents for oxygen and carbon dioxide were significantly lower during leg exercise compared with arm exercise (41.5 ± 9.7 vs 46.6 ± 14.2 and 34.4 ± 8.3 vs 47.0 ± 12.7 L/L, respectively, P < 0.05). Significant correlations were found among VO₂, V(E), tidal volume, and VCO₂ at peak levels of leg and arm exercise. V(E) at peak exercise also showed a significant correlation with the pre-exercise forced expiratory volume in 1 second (FEV₁) during both types of exercise. The authors concluded that, in men with COPD, maximum leg and arm exercise produced similar results in many but not all measurements of respiratory function. The limited capacity of patients with COPD to perform arm exercise might impair development of a clinically significant training effect during a formal program of upper extremity exercise.