Prescribing and adjusting exercise training in chronic respiratory diseases - Expert-based practical recommendations

Area of Science:

• Exercise Physiology
• Pulmonary Rehabilitation
• Clinical Practice Guidelines

Background:

• International guidelines recommend endurance (ET) and strength training (ST) for chronic respiratory diseases (CRDs).
• Current guidance lacks specific details on initial training load prescription and adjustments.
• This variability may lead to suboptimal training and patient outcomes.

Purpose of the Study:

• To develop practical recommendations for tailoring ET and ST in CRD patients.
• To synthesize expert practices in exercise training for CRDs.
• To provide guidance for optimizing exercise interventions in this population.

Main Methods:

• A 64-item online survey was distributed to 35 international experts in exercise training for CRDs.
• Experts were queried on their methods for prescribing and adjusting ET and ST.
• Survey data was analyzed to identify common practices and expert consensus.

Main Results:

• Cycling and walking were the most common ET modalities; continuous (CET) and interval (IET) endurance training were frequently applied.
• Key criteria for prescribing IET over CET included patient intolerance to CET due to dyspnea, intense breathlessness, or oxygen desaturation.
• For ST, experts typically recommended 3 sets per exercise, targeting 8-15 repetitions and advising patients to approach muscular exhaustion.

Conclusions:

• Expert practices were summarized into practical flowchart recommendations for applying and adjusting CET, IET, and ST.
• These recommendations aim to standardize and optimize exercise training programs for patients with CRDs.
• The developed guidelines can assist healthcare professionals in improving exercise prescription for CRD patients.