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Chronic Obstructive Pulmonary Disease and Overtraining Syndrome: A Narrative Review.
Bruno Bordoni1, Enricomaria Mattia2, Bruno Morabito3
1Department of Physical Medicine and Rehabilitation, Fondazione Don Carlo Gnocchi, Milan, ITA.
Cureus
|March 13, 2026
Summary
Pulmonary rehabilitation for Chronic Obstructive Pulmonary Disease (COPD) should incorporate wave-like training, not just increasing loads. This approach helps prevent overtraining syndrome (OTS) and improves patient performance.
Area of Science:
- Pulmonary Rehabilitation
- Exercise Physiology
- Respiratory Medicine
Background:
- Chronic Obstructive Pulmonary Disease (COPD) causes airflow limitation, leading to significant global mortality and morbidity.
- Rehabilitation training is a key non-pharmacological approach for COPD patients, stimulating limb and respiratory muscles.
- Current rehabilitation programs often involve a constant increase in training workloads.
Purpose of the Study:
- To review muscular adaptation in COPD patients undergoing rehabilitation.
- To introduce and emphasize the concept of wave-like training in pulmonary rehabilitation programs.
- To highlight the potential benefits of incorporating reduced-load sessions for recovery and performance.
Main Methods:
- Review of literature on muscular adaptation in COPD patients.
- Analysis of current pulmonary rehabilitation training protocols.
- Conceptual proposal for a wave-like training model versus a linear model.
Main Results:
- Linear increases in training loads without adequate recovery may lead to overtraining syndrome (OTS).
- OTS is characterized by an unexplained decline in patient performance.
- A wave-like training structure, including reduced-load sessions, is proposed as an alternative.
Conclusions:
- Clinicians should consider structuring COPD rehabilitation programs in a wave-like, rather than linear, fashion.
- Incorporating periods of decreased training intensity can aid recovery and reduce the risk of OTS.
- Wave-like training may enhance patient performance and adherence during pulmonary rehabilitation.
Keywords:
american thoracic societycopddiaphragmeuropean respiratory societyfev1inspiratory muscle trainingmaximal inspiratory pressureovertraining syndromerehabilitation trainingMore Related Videos
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