Chest wall kinematics and breathlessness during unsupported arm exercise in COPD patients

Isabella Romagnoli, Francesco Gigliotti, Barbara Lanini, Giulia Innocenti Bruni, Claudia Coli, Barbara Binazzi, Loredana Stendardi, Giorgio Scano

Research output: Contribution to journalArticlepeer-review


We hypothesised that chest wall displacement inappropriate to increased ventilation contributes to dyspnoea more than dynamic hyperinflation or dyssynchronous breathing during unsupported arm exercise (UAE) in COPD patients. We used optoelectronic plethysmography to evaluate operational volumes of chest wall compartments, the upper rib cage, lower rib cage and abdomen, at 80% of peak incremental exercise in 13 patients. The phase shift between the volumes of upper and lower rib cage (RC) was taken as an index of RC distortion. With UAE, no chest wall dynamic hyperinflation was found; sometimes the lower RC paradoxed inward while in other patients it was the upper RC. Phase shift did not correlate with dyspnoea (by Borg scale) at any time, and chest wall displacement was in proportion to increased ventilation. In conclusions neither chest wall dynamic hyperinflation nor dyssynchronous breathing per se were major contributors to dyspnoea. Unlike our prediction, chest wall expansion and ventilation were adequately coupled with each other.

Original languageEnglish
Pages (from-to)242-249
Number of pages8
JournalRespiratory Physiology and Neurobiology
Issue number2
Publication statusPublished - Sept 15 2011


  • Arm exercise
  • Dyspnoea
  • Operational lung volumes
  • Optoelectronic plethysmography
  • Rib cage paradox

ASJC Scopus subject areas

  • Physiology
  • Pulmonary and Respiratory Medicine
  • Neuroscience(all)


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