{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:39:11Z","timestamp":1791578351570,"version":"4.3.4"},"reference-count":32,"publisher":"European Respiratory Society (ERS)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2011,5,5]]},"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:p>There is strong evidence that exercise training, constituting the cornerstone of pulmonary rehabilitation, improves exercise tolerance, dyspnoea sensations, functional capacity and quality of life in patients with severe chronic obstructive pulmonary disease. However, intolerable sensations of breathlessness and\/or peripheral muscle discomfort may prevent such patients from tolerating high-intensity exercise levels for sufficiently long periods of time to obtain true physiological training effects.<\/jats:p><jats:p>Accordingly, the major issue that arises is the selection of the appropriate training strategy, which is tailored to the cardiovascular, pulmonary and peripheral muscle limitations of the individual patient and is aimed at maximising the effect of exercise conditioning.<\/jats:p><jats:p>Within this context, the present article explores the application of strategies that optimise exercise tolerance by reducing dyspnoea sensations, namely noninvasive mechanical ventilation, oxygen and\/or heliox supplementation. Administration of heliox or oxygen during exercise also increases peripheral muscle oxygen delivery, thereby delaying the onset of peripheral muscle fatigue. Particular emphasis is also given to interval exercise and resistance-muscle training as both modalities allow the application of intense loads on peripheral muscles with tolerable levels of dyspnoea sensations.<\/jats:p><jats:p>In patients with profound muscle weakness and intense breathlessness upon physical exertion, execution of short bouts of interval or local muscle strength conditioning, along with oxygen breathing, may constitute a feasible and effective approach to pulmonary rehabilitation.<\/jats:p>","DOI":"10.1183\/09031936.00075011","type":"journal-article","created":{"date-parts":[[2011,7,8]],"date-time":"2011-07-08T14:48:08Z","timestamp":1310136488000},"page":"971-975","source":"Crossref","is-referenced-by-count":41,"title":["Strategies of muscle training in very severe COPD patients: Figure 1\u2013"],"prefix":"10.1183","volume":"38","author":[{"given":"I.","family":"Vogiatzis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2011,7,7]]},"reference":[{"key":"2024102020450427000_38.4.971.1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200508-1211ST"},{"key":"2024102020450427000_38.4.971.2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/143.1.9"},{"key":"2024102020450427000_38.4.971.3","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1164\/ajrccm.155.2.9032194","article-title":"Intensity of training and physiologic adaptation in patients with chronic obstructive pulmonary disease","volume":"155","author":"Maltais","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"key":"2024102020450427000_38.4.971.4","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00002904"},{"key":"2024102020450427000_38.4.971.5","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1164\/ajrccm\/138.5.1185","article-title":"Effect of continuous positive airway pressure on respiratory sensation in patients with chronic obstructive pulmonary disease during submaximal exercise","volume":"138","author":"O'Donnell","year":"1988","journal-title":"Am Rev Respir Dis"},{"key":"2024102020450427000_38.4.971.6","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.57.10.853"},{"key":"2024102020450427000_38.4.971.7","doi-asserted-by":"publisher","DOI":"10.1097\/00008483-200105000-00003"},{"key":"2024102020450427000_38.4.971.8","unstructured":"O'Donnell DE . Exertional breathlessness in chronic respiratory disease. In: Mahler DA, ed. Dyspnoea. Lung Biology in Health and Disease. Vol. 111. 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Effect of pulmonary rehabilitation on peripheral muscle fiber remodelling in COPD patients with GOLD stages II to IV. Chest 2011; [Epub ahead of print. 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