Effect of Different Form of Upper Limb Muscles Training on Dyspnea in COPD

Study Overview
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Brief Summary
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Evaluate the effect of upper limbs strength training versus the effect of upper limbs endurance training, on dyspnea, in patients with COPD during a pulmonary rehabilitation program.

Official Title
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Effect of Different Form of Upper Limb Muscles Training on Dyspnea in COPD

Conditions
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COPD

Intervention / Treatment
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* Other: Strength training
* Other: Endurance training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient with stage 2 to 4 (A to D) COPD admitted to a pulmonary rehabilitation program (4 weeks) Patient aged 18 or over Patient able to consent and having signed a consent form Exclusion Criteria: Patient with pain, osteoarthritis or shoulder surgery Patient with a history of Pneumonectomy, lobectomy less than 6 months old Refusal of participation Patient with an inability to complete a pulmonary rehabilitation program in totality Pregnant or breast-feeding women Patient under tutorship or curatorship

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: This is a multicenter, prospective, randomized, open-label study.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Strength<br>Patients will follow the pulmonary rehabilitation program associated with upper limbs strength training for a duration of 4 weeks | Other: Strength training<br>* Upper limbs Strength training; done with dumbbells whose weight corresponds to 60-80% of the maximal voluntary force in abduction measured initially, during 4 weeks<br>|
| Active Comparator: Endurance<br>Patients will follow the pulmonary rehabilitation program associated with upper limbs endurance training for a duration of 4 weeks | Other: Endurance training<br>* Upper limbs Endurance training of the ; done with dumbbells whose weight corresponds to 30% of the maximum voluntary force in abduction measured initially, during 4 weeks<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Compare the effect of upper limbs strength training versus the effect of upper limb endurance training on dyspnea in patients with COPD during a pulmonary rehabilitation program. | Measurement of dyspnea using the London Chest Daily Activity Living (LCADL) questionnaire. This 15-item, self-administered questionnaire allows an evaluation of dyspnea in patients with COPD during daily activities divided into four components: self-care, domestic, physical, and leisure. Patients could score from 0: I would not do anyway to 5: I need someone else to do this. LCADL score is calculated by aggregating the points assigned to each question, with a higher score representing maximal disability. | Change from inclusion at 4 week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Compare dyspnea in daily life between the 2 groups | Measurement of dyspnea using mMRC scale. mMRC dyspnea scale is the first self-administered scale which assesses the impact of dyspnea on ADL. It consists of five grades increasing in severity of chronic respiratory disease from 0 : I only get breathless with strenuous exercise to 4 : I am too breathless to leave the house or I am breathless when dressing or undressing. | At inclusion and week 4 | 
| Compare dyspnea in daily life between the 2 groups | Measurement of dyspnea using Dyspnea-12 questionnaire. This 12-item self-administered questionnaire measures dyspnea severity in both its physical and affective components, independently from activity limitation. Patients score ranges from none (corresponding to score 0) to severe (score 3). Dyspnea-12 score is calculated by aggregating the points assigned to each question; the higher the score, the greater the severity. | At inclusion and week 4 | 
| Measuring upper limb endurance | with the 6-minute Peg Board and Ring Test (6PBRT) | At inclusion and week 4 | 
| Compare dyspnea at the end of a functional test using the upper limbs | Measurement of dyspnea with Borg scale at the end of 6PBRT. The measure is a rating on a scale from 0 to 10 attached to different words of appreciation: very light, difficult, painful ... effort. | At inclusion and week 4 | 
| Compare upper limbs muscle fatigue at the end of a functional test using the upper limbs | Measurement of upper limbs muscle fatigue with Borg scale at the end of 6PBRT. The measure is a rating on a scale from 0 to 10 attached to different words of appreciation: very light, difficult, painful ... effort. | At inclusion and week 4 | 
| Compare the evolution of upper limb strength between the 2 groups. | Measurement of the strength of deltoids, biceps and brachial triceps, with hand held dynamometer | At inclusion and week 4 |