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Abstract
In our study, each patient determined his or her rate of unsupported arm exercise, and we did not measure the rate, since the purpose was to evaluate the changes in respiratory variables during activities similar to those that generated dyspnea as observed in the clinical setting (teeth brushing, hair combing, and face grooming). [...]we have presented preliminary evidence from another study that dyssynchronous excursions of the upper thorax and abdomen can occur when normal subjects perform similar unsupported exercise.1 We welcome Dr. Kirby's suggestions about developing protocols to evaluate the timing of respiration and arm exercise, and we are conducting such research. Much has to be learned about the way in which human beings coordinate their respiration with limb activities, especially since such information is already available for birds and for quadrupeds.2 It is interesting that the integration of exercise and respiration in runners is more complex, with locomotor-respiratory coupling ratios that range from 1:1 to 4:1, rather than the usually fixed 1:1 reported in dogs and horses.2 1.