Upper body training

Upper body training is necessary for COPD patients as upper limb activities are particularly important for independent daily life. For example, dressing, bathing, and daily household chores require upper limb participation. The diaphragm’s mechanical efficiency decreases in patients due to lung hyperinflation. Therefore, accessory inspiratory muscles such as the latissimus dorsi, trapezius, and pectoralis major and minor muscles assist ventilation to some extent. When these muscle groups are used for daily upper limb movements, the diaphragmatic load will increase and has a higher demand for metabolism and ventilation, thus resulting in irregular, shallow, and uncoordinated breathing and dyspnea. These symptoms can be effectively improved by training and the upper body movement ability in COPD patients can also be enhanced (25). However, it is unknown whether upper body training is more effective for improving health-related quality of life (26).

Upper body training also includes aerobic and resistance training. At present, there is no recommendation for the best program for COPD patients. According to whether the upper limb is supported, upper body training is also divided into unsupported and supported training. Unsupported upper body training focuses on resistance training of the biceps, deltoids, triceps, and trapezius muscles using dumbbells. Generally, the initial load is 50% 1-RM, and the intensity can be gradually increased if the Borg score ≤3 (25). Upper body exercises can be supporting using a cycle ergometer or rowing machine. Studies have shown that six weeks of upper body aerobic training in patients with COPD can increase endurance, regulate hyperventilation, and significantly reduce minute ventilation under the same conditions (27).