Vol. 5, Issue 11, Part D (2019)

Background: COPD is a slowly progressive, inflammatory disease in the airways and lungs due to noxious particles or gases. COPD is amongst the leading cause of chronic diseases in India. WHO estimates suggest that 90% of COPD-related deaths occur in low and middle income population. Most patients of COPD are aged more than 40 years. The main risk factors are tobacco smoke in male and indoor biomass fuel exposure in female. The chronic airflow limitation leads to dyspnea and is associated with the development of limb muscle dysfunction. Spirometry is the gold standard for diagnosis of COPD. Unsupported upper limb exercise training programs can be used to reduce dyspnea in COPD patients by improving the breathing pattern by strengthening the accessory muscles of respiration.

Aims and Objectives: To measure and compare the association between lung function parameters and upper limb muscle strength and endurance.

Materials and Methods: The present study is a prospective, interventional single centered hospital based study conducted from February 2016 to February 2019 for a duration of 36 months in the Department of Pulmonary medicine, Gauhati Medical College and Hospital, Guwahati after getting approval from the Institutional Human Ethics committee. All patients diagnosed with COPD above 40 years of age irrespective of gender and giving proper written informed consent were included in this study.

Results: In the present study, a total of 100 patients diagnosed with COPD were included. Initially at first visit, the average hand grip muscle strength was found to be 39.75 +7.084 kg but it significantly increased after 8 weeks of continuous upper limb exercise training with hand held dynamometer to 46.41+6.252 kg. On first visit, the mean FEV1 value of all the patients was 62.3+ 6.480 %, the mean MMRC grading of dyspnea was 2.65+ 0.479 and the average distance covered on 6 minute walk test (6MWT) was 339.95 +34.7842 meters. On doing regular upper limb exercise with the hand held dynamometer for a duration of 8 weeks along with the prescribed bronchodilators and inhaled corticosteroids the mean FEV1 value, the mean MMRC grading and the average distance covered on 6MWT significantly improved to 73+ 5.853%, 1.87+ 0.338 and 408.54 +24.6016 meters respectively.

Conclusion: In the present study, it was observed that unsupported upper limb training with hand held dynamometer for patients with COPD improves upper limb exercise capacity, the lung volume and decreases dyspnea grading in a significant manner. So, upper limb exercise training program should be included in treatment regimen of COPD patients along with the pharmacotherapy in order to improve their quality of life, to reduce episodes of acute exacerbations, to reduce the rate of hospital admissions and finally mortality rate.