On the design and effectiveness of training regimes in chronic obstructive lung disease

Most patients with chronic obstructive lung disease (COLD) show a favourable response to progressive endurance training. Symptomatology is reduced and effort tolerance is extended. However, there is little change of pulmonary function scores. Possible explanations of the clinical gains include 1) psychological encouragement, 2) improvements of mechanical efficiency, 3) restoration of cardiovascular fitness, thus breaking a vicous circle of dyspnoea, inactivity and worsening dyspnoea, 4) strengthening of the body musculature, thus reducing the proportion of anaerobic work, 5) biochemical adaptations reducing glycolysis in the active tissues, and 6) indirect responses to such factors as group support, with advice on smoking habits, breathing patterns and bronchial hygiene. tdespite immediate gains of performance, there is no reason to believe exercise can restore destroyed pulmonary tissue. Further study is thus needed to test whether training can influence long-term prognosis in COLD.