Unsupported Upper Limb Endurance Training: An Alternative to Improve Functional Capacity & Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

A 78 yrs old lady, a known case of chronic obstructive pulmonary disease (COPD) & bilateral severe osteoarthritis knee, referred for pulmonary rehabilitation; presented with dyspnoea grade IV on MRC scale, sputum production and restricted activities of daily living (ADL) due to the dyspnoea, fatigue along with limb muscle weakness during activities. Pulmonary function test (PFT) showed moderate obstruction. Patient was put on an individually tailored pulmonary rehabilitation program emphasizing on unsupported upper limb endurance training for three months as patient was unable to exercise with lower limbs due to knee pain. Three months post rehabilitation, though PFT did not show a significant improvement; patient reported functional independence; objectively measured as improved chronic respiratory disease questionnaire (CRDQ) scores & increased six minute walk distance (6MWD). Hence, an individually tailored pulmonary rehabilitation program involving unsupported upper limb endurance training improves functional and psychological outcomes in patients with COPD.