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Exercise and Training in Patients with Chronic Obstructive Lung Disease

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Summary

Exercise protocols and training are used more and more in diagnostic procedures and as a tool in improving physical, social and psychological functioning in chronic obstructive lung disease patients.

Before starting a training programme in chronic obstructive lung disease patients, one should exclude ventilatory-limited patients from the group. A maximal ergometer test with arterial blood samples or pulse oximetry must be performed.

In mild forms of chronic obstructive lung disease with no ventilatory insufficiency de-monstrable with exercise testing, the patient can be trained with no restrictions. Endurance training is permitted. It should be noted that it is possible to train the muscular and cardiovascular system up to a new, possible ventilatory maximum.

In severe chronic obstructive lung disease endurance training is accompanied by hy-poxia, with an associated risk of rhythm disturbances and right heart failure. Training with supplemental oxygen can reduce this risk, but should be done only under close medical supervision.

In very severe chronic obstructive lung disease, when endurance training is only marginally possible even with supplemental oxygen, suppleness, coordination and relaxation exercises should be emphasised in rehabilitation programmes. Postural exercises and breathing control exercises can also give great subjective improvements in this often very disabled group of patients. Furthermore they can reduce fear and panic when dyspnoea occurs.

Training of the respiratory muscles in patient with chronic obstructive lung disease must be regarded as an experimental therapy. The clinical importance remains uncertain.

Exercise-induced bronchoconstriction should not limit exercises or training, provided it is treated correctly.

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Authors and Affiliations

  1. Department of Pulmonary Diseases, University of Nymegen, Medical Centre Dekkerswald, Groesbeek, The Netherlands

    N. J. M. Cox, C. L. A. van Herwaarden, H. Folgering & R. A. Binkhorst

  2. Department of Physiology, University of Nymegen, Nymegen, The Netherlands

    N. J. M. Cox, C. L. A. van Herwaarden, H. Folgering & R. A. Binkhorst

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  1. N. J. M. Cox
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  2. C. L. A. van Herwaarden
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  3. H. Folgering
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  4. R. A. Binkhorst
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Cox, N.J.M., van Herwaarden, C.L.A., Folgering, H. et al. Exercise and Training in Patients with Chronic Obstructive Lung Disease. Sports Medicine 6, 180–192 (1988). https://doi.org/10.2165/00007256-198806030-00005

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