This study demonstrates that patients with chronic obstructive pulmonary disease (COPD) are able to perform endurance exercise training at high percentages of maximal exercise tolerance. Fifty patients with COPD entering a pulmonary rehabilitation program underwent pulmonary function and exercise testing to assess exercise tolerance and to derive training prescriptions. Forty-five of the 50 patients began an exercise program of walking at levels estimated to approach maximal exercise tolerance for most patients, After six weeks, all patients maintained or increased initial walking speed; most patients also maintained or increased distance walked per session. The results indicate that: (1) patients with COPD can sustain levels of exercise at higher percentages of maximum than other patients or healthy persons; (2) even patients with severe disease can successfully undergo training that emphasizes endurance; (3) anaerobic threshold could not be detected by gas-exchange techniques in most patients; and (4), when detected, anaerobic threshold occurred at a higher percentage of maximum than in healthy persons. These results highlight some of the differences in exercise principles among pulmonary patients, other patients, and healthy persons. When including exercise in training program plans or when estimating tolerance for sustained physical activity (e.g., for disability evaluations), one should consider the ability of patients with COPD to perform sustained exercise at high percentages of maximum.
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Ries et al. (1987) studied this question.