Exercise and Disease Management

Abstract

Physical exercise therapy is one of the most important nonpharmacological options for patients with chronic respiratory and pulmonary diseases. The positive effects on physical performance, dyspnea, quality of life and prognosis have been proven at the highest level of evidence. To achieve optimal positive effects, exercise training must be planned and managed based on individual patient diagnostics and goals. After a previously defined period of training, diagnostic assessments should be repeated to observe the progress achieved and to update goals and training loads to maintain an effective physiological stimulus. A combination of endurance and strength training has proven to be particularly effective as an exercise training program for people with pulmonary disease. Constant work rate and interval training are two methods of endurance training and the effectiveness is comparable between them. Strength training can take the form of muscle endurance training or as hypertrophy training, depending on the individual training level and the quality of exercise execution. The focus of strength training should be placed on the leg muscles as this is where the muscle atrophy is usually most pronounced, resulting in the greatest limitations for the patient in everyday life. The combined endurance and strength training can be supplemented by other training tools, such as whole-body vibration training. It is beneficial to begin training during an inpatient pulmonary rehabilitation program in order to ensure optimization of training parameters as well as clinical monitoring, especially of blood oxygenation, during supervised training sessions.