Long-Term Exercise Therapy for Chronic Obstructive Lung Disease

Abstract

13 patients with chronic obstructive lung disease – 6 with emphysema (E) or emphysema + chronic bronchitis (EB), 7 with pure chronic bronchitis (B) – undertook during 1 year a progressive endurance training, 6 of the subjects continuing for a second year. The E patients were generally more disabled than the B patients, with less lean tissue, poorer muscular endurance, and CO₂ retention during exercise. However, initial tolerance of submaximal aerobic work (65% of age-related normal) was comparable in E and B patients. Eight of the 13 patients noted symptomatic improvements over the first year of conditioning, with reductions of heart rate at a standard submaximal work load and gains of predicted aerobic power (8% in E, 15% in B). Larger improvements were usual in those who exercised faithfully. Gains over the year included increases of muscular endurance (B > E), a small reduction of oxygen debt, a diminution of air trapping and CO₂ retention (E group), and a cessation of deterioration in lung volumes (B group). Symptomatic improvements reflect the support of an interested medical team, increases of muscle strength and gains of cardio-respiratory condition. Training breaks the vicious circle of dyspnoea, inactivity and worsening dyspnoea. The apparent arrest of declining lung volumes in B patients merits confirmation on a larger sample observed for a longer period