© 2005 BMJ Publishing Group Ltd & British Thoracic Society
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Pulmonary rehabilitation is now an integral part of the management of patients with COPD and improves exercise capacity and health status. However, patients can be provided with physical training in many different ways and there is little information on the optimum training modes. In this issue of Thorax Puhan and colleagues evaluate, in a systematic review, the current evidence on different exercise modalities in COPD. They show that strength training provides greater improvements in health status than endurance exercise and conclude that strength training should be routinely incorporated into rehabilitation programmes. Interval exercise during training should work better than continuous exercise, but the evidence in the review for advantages of interval training was poor and no conclusion could be drawn about the relative benefits of these exercise modalities in COPD. There was also insufficient evidence to recommend high intensity exercise, and the authors conclude that further trials are needed to
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