Assessment of Exercise Capacity: A Key Element in Pulmonary Rehabilitation

Abstract

Pulmonary rehabilitation (PR) is an extremely effective treatment for people with chronic lung disease, including post-COVID-19, which is still underused worldwide. The capacity for effort and its increase through physical training is a key element that underlies the PR programs being recognized by all specialists in the field in the guides of the American Thoracic Society (ATS)/European Respiratory Society (ERS), American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), American College of Sports Medicine (ACSM), Global Initiative for Chronic Obstructive Lung Disease (GOLD), etc. The evaluation helps to determine the factors that limit it (ventilators, cardiovascular and muscular factors, etc.), to prescribe the intensity of training, to detect the contraindications of PR, and to evaluate the effectiveness of the rehabilitation program (improving exercise capacity, reducing exercise dyspnea, etc.). In clinical practice, we use two types of investigations on exercise capacity: maximal test (cardiopulmonary exertion test) and submaximal test (6-minute walk test). Based on the systematic review of recent literature and our clinical experience, the chapter will highlight issues related to PR, exercise capacity, and physical training (aerobic, endurance, respiratory muscle) in patients with chronic lung disease.