The treatment of patients suffering from chronic obstructive pulmonary disease (COPD) relies chiefly on smoking cessation. Bronchodilators and certain vaccinations are also helpful. Some clinical guidelines recommend respiratory rehabilitation, which includes physical exercise, respiratory education, and psychosocial and nutritional support.

A systematic review collated the results of all the trials evaluating the effectiveness of physical exercise for COPD patients. The programmes comprised various upper- and lower-limb exercises, and did not focus solely on the respiratory muscles. The main evaluation criterion was the quality of life in the 3 months following the programme, assessed on the basis of questionnaires drawn up specifically for respiratory disease.

Sixty-five trials involving a total of 3822 patients were analysed. Overall, among patients doing the exercises, the quality of life improved to a statistically significant extent deemed clinically pertinent for each of the criteria on the evaluation scales. No adverse effects were reported.

In the absence of a strategy for maintaining physical fitness, the effects of this type of training appeared to wear off after 6 to 12 months. Repeating the exercise programme seems to have the same beneficial effect as the initial programme.

The harm-benefit balance of these programmes seemed favourable for patients prepared to exercise regularly.

©Prescrire 1 March 2016

"COPD: benefits of exercise training" Prescrire Int 2016; 25 (169): 76-77. (Pdf, subscribers only).