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Interval versus continuous training in individuals with COPD - a systematic review
  1. Marla K Beauchamp1,
  2. Thomas E Dolmage2,
  3. Mika Nonoyama1,
  4. Roger S Goldstein2,
  5. Kylie Hill2,
  6. Sunita Mathur1,
  7. Dina Brooks1,*
  1. 1 University of Toronto, Canada;
  2. 2 West Park Healthcare Centre, Canada
  1. Correspondence to: Dina Brooks, Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, M5G 1V7, Canada; dina.brooks{at}


Background: In patients with COPD, interval exercise has gained recent attention as a possible means of achieving greater physiologic training effects compared to continuous exercise. The primary aim of this systematic review was to compare the effects of interval versus continuous training on peak oxygen uptake (VO2peak), peak power (Ppeak), Six-Minute Walk Test (6MWT) distance and health-related quality of life in individuals with COPD.

Methods: Randomized controlled trials (RCTs) comparing the effects of interval versus continuous training in patients with COPD were identified after searches of six databases and reference lists of appropriate studies in May 2009. Two reviewers independently assessed study quality. Weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated using a random-effects model for measures of exercise capacity and health-related quality of life.

Results: Eight RCTs, with a total of 388 COPD patients, met the inclusion criteria. No significant differences were found for Ppeak (WMD 1 W, 95% CI -1 to 3) or VO2peak (WMD -0.04 L/min, 95% CI -0.13 to 0.05) between interval and continuous training. The WMD for the Chronic Respiratory Questionnaire dyspnea score was -0.2 units (95% CI -0.5 to 0.0). There was no difference in 6MWT distance between groups (WMD 4 m, 95% CI -15 to 23).

Conclusions: Interval and continuous training modalities did not differ in their effect on measures of exercise capacity or health-related quality of life. Interval training may be considered as an alternative to continuous training in patients with varying degrees of COPD severity.

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