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High versus low intensity exercise training in pulmonary rehabilitation: is more better?

Department of Pulmonary and Critical Care Medicine, Manchester Hospital, Manchester, USA

R ZuWallack

Department of Pulmonary and Critical Care Medicine, St Francis Hospital and Medical Center, Hartford, USA

Background:Exercise training is considered a necessary component of comprehensive pulmonary rehabilitation. However, to date, there is no consensus on an exercise training strategy for pulmonary rehabilitation, and this has resulted in varied approaches to this intervention in its literature. As in healthy individuals, the effect of exercise training on patients with chronic lung disease is dose dependent, with higher intensities resulting in greater physiological adaptations than lower intensities. Results:It is not clear from our review of the literature that these enhanced physiological effects from higher levels of exercise training translate into a reduced burden of symptoms, hence a better quality of life. Indeed, there is some evidence that pulmonary rehabilitation approaches incorporating lower intensities of exercise training are at least as good in improving questionnaire rated symptoms of health status. This provides food for thought, since the prominent goal of pulmonary rehabilitation should be to reduce bothersome symptoms or enhance health status, not simply increase endurance time on a cycle ergometer.

Key Words: exercise • health status • pulmonary rehabilitation • quality of life

Chronic Respiratory Disease, Vol. 1, No. 3, 143-149 (2004)
DOI: 10.1191/1479972304cd018oa


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