End-Expiratory Lung Volume during Arm and Leg Exercise in Normal Subjects and Patients with Cystic Fibrosis

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Abstract
There are no reports concerning the regulation of end-expiratory lung volume (EELV) and flow-vol- ume relationships during upper limb exercise in health and disease. We studied EELV during such ex- ercise in 22 adults with cystic fibrosis (CF) and nine age-matched healthy control subjects. Subjects with CF were grouped according to the severity of their lung disease, as follows: mild 5 FEV 1 . 80% predicted; moderate 5 FEV 1 40 to 80% predicted, and severe 5 FEV 1 , 40% predicted. EELV was cal- culated from measurements of inspiratory capacity (IC) made at each workload during an incremen- tal arm and leg ergometer test to peak work capacity. In the control group, the decrease in EELV was significantly smaller for arm than for leg exercise at peak work ( 2 0.13 L versus 2 0.53 L, p , 0.001) and for arm than for leg exercise at an equivalent submaximal ventilation ( 2 0.13 L versus 2 0.46 L, p , 0.01). In the groups with moderate and severe CF, arm exercise resulted in an increase in EELV from resting levels (dynamic hyperinflation) that was not significantly different from the increase ob- served for leg exercise. For CF subjects there was a significant inverse relationship between FEV 1 and changes in EELV from rest to peak arm exercise (r 5 2 0.46, p , 0.05). In normal subjects, there was a difference in the EELV response for arm versus leg exercise. In CF subjects with airflow limitation, dy- namic hyperinflation occurred with both forms of exercise. Alison JA, Regnis JA, Donnelly PM, Ad- ams RD, Sullivan CE, Bye PTP. End-expiratory lung volume during arm and leg exercise in normal subjects and patients with cystic fibrosis. AM J RESPIR CRIT CARE MED 1998;158:1450-1458.

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