EXERCISE TRAINING
Endurance Training
Endurance exercise training is typically prescribed three to five
times per week. A high level of intensity of continuous exercise
(.60% maximal work rate) for 20 to 60 minutes per session
maximizes physiologic benefits (i.e., exercise tolerance, muscle
function, and bioenergetics) (5). Before starting an exercise
training program, an exercise assessment is needed to individualize
the exercise prescription, evaluate the potential need for
supplemental oxygen, help rule out some cardiovascular comorbidities,
and help ensure the safety of the intervention (6–11).
There has been increased awareness of the efficacy of leisure
walking as a mode of exercise training in chronic obstructive pulmonary
disease (COPD). For example, indoor ground walk
training increased endurance walking capacity more than cycle
training and was similar to stationary cycle training in improving
peak walking capacity, peak and endurance cycle capacity and
quality of life (12). Moreover, a randomized, controlled trial
of a 3-month outdoor Nordic walking exercise program (vs. control)
in 60 patients with COPD resulted in significant improvements in
exercise capacity and physical activity. These gains were sustained
at 6 and 9 months after the initial intervention (13).