BACKGROUND: The partition and chronological sequence of the different training items and modalities necessary for an effective training of patients with chronic obstructive pulmonary disease (COPD) remains a subject of debate. We investigated the combination of effective components of pulmonary rehabilitation in the settings outpatient lung sports group, home-based training and training in a gym. METHODS: Subjects were randomized to a 12-month training program and a no training group. PATIENTS AND MAIN RESULTS: The training group (n = 10, mean age 62.5 years, FEV1 53.4% predicted) reached an average increase in peakVO2 of 10% (p = 0.01) from 1.30 +/- 0.41 L/minute to 1.44 +/- 0.38 L/minute, in peak work rate of 14% (p = 0.007) from 82 +/- 39 W to 93 +/- 43 W and in the six-minute walking distance of 79 meters (p = 0.003), whereas in the control group (n = 9, mean age 63.2 years, FEV1 53.7% predicted) no significant changes were observed. The quality of life obtained by use of the SF36-questionnaire and SGRQ also significantly improved in the training group, but not in the control group. CONCLUSION: This outpatient rehabilitation program is effective and appropriate for long-term rehabilitation of patients with COPD.

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