• Nicolino Ambrosino and Guido Vagheggini.
• Pulmonary Unit, Cardio-Thoracic Department, University Hospital, Pisa, Italy. n.ambrosino@ao-pisa.toscana.it
• Int J Chron Obstruct Pulmon Dis. 2006 Jan 1;1(4):355-61.

AbstractPatients with chronic obstructive pulmonary disease (COPD) are often limited in their activities by breathlessness. In these patients, exercise training may result in significant improvements in dyspnea, exercise tolerance, and health related quality of life (HRQoL). Further possibilities are to reduce ventilatory demand by decreasing the central respiratory drive or to lessen the perceived breathing effort by increasing respiratory muscle strength through specific respiratory muscle training. Upper limb training may also improve exercise capacity and symptoms in these patients through the modulation of dynamic hyperinflation. Ventilatory assistance during exercise reduces dyspnea and work of breathing and enhances exercise tolerance, although further studies should be required to define their applicability in the routine pulmonary rehabilitation programs. Lung volume resection surgery and lung transplantation in selected patients may control symptoms and improve HRQoL.

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