[Exercise training in chronic pulmonary disease]

Exercise training has become a cornerstone of Pulmonary Rehabilitation. Since the nineties, the effectiveness in clinically relevant improvements in exercise capacity and health-related quality of life has been proved. Current guidelines (Evidence A) recommend high intensity continuous exercise for lower extremities as the most effective exercise modality, however, for some patients it is often difficult to initiate such an exercise programme due to the limitation of dyspnoea or leg fatigue. In recent years, special relevance has been given to the integration of other modalities of exercise (continuous versus interval, aerobic versus strength, inclusion or not of respiratory muscle training). The authors carry out a review of the current literature concerning exercise training in chronic pulmonary disease and this highlights the role of tailored exercise to break the vicious cycle of dyspnoea and inactivity.