Aerobic Exercise for Individuals with Chronic Obstructive Pulmonary Disease

Purpose: Pulmonary rehabilitation has been found to consistently improve exercise capacity, quality of life, and symptoms in individuals with chronic obstructive pulmonary disease (COPD). Different types of exercise can be integrated into a pulmonary rehabilitation program. For the purposes of this article, we focus specifically on aerobic exercise, providing recommendations for optimal aerobic exercise prescription in individuals with COPD. Summary of Key Points: Individuals with all degrees of severity of COPD can benefit from participation in an exercise-training program in inpatient, outpatient, or home-based settings. Aerobic exercise training using the large muscle groups of the lower extremities, via ground-based walking, a treadmill, a cycle ergometer, or a combination of all three modalities, is preferred. High-intensity training yields significant physiological improvements in aerobic fitness. However, in individuals with COPD, training intensity should be guided by patient tolerance and safety. Interval training is an alternate option for patients who cannot sustain continuous periods of high-intensity exercise. Individuals with COPD should aim to exercise at least three to five times per week, completing 20 to 30 minutes per session. Conclusions: The clinical recommendations provided serve as a guide to help optimize aerobic fitness in individuals with COPD. As with all exercise prescriptions, clinicians should consider the individual needs and goals of the patient when designing an aerobic exercise program.