Abstract

There is strong evidence suggesting a measurable improvement of the condition in patients with coronary heart disease following a period of physical training. However, it is not well established if patients with chronic lung diseases will also benefit from regular physical activity. Due to the different pathophysiological situation in lung and heart diseases, we can not simply transfer our scientific data and practical experiences with exercise programs obtained in heart patients to patients with lung diseases. The necessary increase in O2 uptake during aerobic exercise of longer duration is impaired in patients with lung disease in different pathophysiological ways: decreased ventilation, perfusion, or diffusion or in combination. The most common result of clinical examination is the chronic obstructive lung disease (COLD: obstructive bronchitis/bronchial asthma). Depending on stage and occurrence of complications (emphysema, hyperreagibility, pulmonary hypertension) these patients can achieve only 25 or 50 Watts but sometimes in an asymptomatic interval even 150 Watts and more. Of particular interest is a special form of bronchial asthma, which is induced by exercise. The diagnosis can only be established by a standardized exercise test. Pharmacological intervention can considerably improve exercise performance in patients with COLD and alter heart rate behavior. In patients with pulmonary fibrosis the diffusion capacity is decreased, often implying a distinct drop in arterial O2 concentration already on a low work load. Verf.-Ref.