Download PDF
Pneumologie 2006; 60(11): 716-723
DOI: 10.1055/s-2006-944318
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Empfehlungen zur Planung und Durchführung des körperlichen Trainings im Lungensport[1]

Recommendations for Planning and Realisation of Exercise Training in Outpatient Lung Sports GroupsO.  Göhl1 , K.  Pleyer2 , G.  Biberger3 , K.  Taube4 , C.  Müller5 , H.  Worth1
  • 1 Medizinische Klinik I, Klinikum Fürth
  • 2 Hochgebirgsklinik Davos
  • 3 Asthmazentrum Buchenhöhe
  • 4 Atem-Reha Hamburg
  • 5Fachklinik Allgäu
Further Information

Publication History

eingereicht 12. 6. 2006

akzeptiert 28. 8. 2006

Publication Date:
16 November 2006 (online)

Also available at
   Permissions and Reprints

Zusammenfassung

Asthma und COPD zählen zu den Volkskrankheiten, die hohe Kosten verursachen. In den nationalen und internationalen Leitlinien wird das körperliche Training als wichtigster nichtmedikamentöser Baustein angeführt. Sowohl bei Asthma bronchiale als auch bei COPD ist evidenzbasiert, dass Effekte in den Bereichen Leistungsfähigkeit, Lebensqualität und gesundheitsökonomische Kosten erreicht werden.

Daher sollten flächendeckend Möglichkeiten zur Durchführung des körperlichen Trainings etabliert werden. Das bedeutet, dass neben den stationären Rehabilitationseinrichtungen im ambulanten Bereich vermehrt Lungensportgruppen gegründet werden müssen, die ein kontinuierliches Training ermöglichen.

Für diese spezielle Form des längerfristigen Trainings in Gruppen gibt es bisher noch keine systematische Darstellung. Erschwerend sind ferner die unterschiedliche Grundausbildung der Fachübungsleiter und die Heterogenität der Teilnehmer. Absicht der Autoren war es, Empfehlungen für ein gegliedertes und zielgruppenspezifisches Training zu erstellen, um die praktische Umsetzung dem evidenzbasierten Wissensstand anzunähern und zur Qualität des Trainings bei Patienten mit Lungenkrankheiten beizutragen.

Abstract

Asthma and COPD are common diseases inducing high costs. In national and international guidelines exercise training is stated as the main component amongst the nonmedical treatment options. With exercise training beneficial effects in exercise performance, quality of life and health-related costs can be obtained. Options for exercise training all over the country should be established. Therefore not only inpatient, but also outpatient structures, especially lung sports groups have to be organized to enable a continuous training.

For this special way of long term training no systematic guidelines do exist. Further aggravating factors are the different basic vocational education of the trainers and the heterogeneity of the participants.

The intention of the authors was to develop recommendations for a structured training and training sensitive to the target group. The realisation of training with this approach should approximate training to evidence based knowledge and contribute to the quality of training patients with lung diseases.

1 Durchführende Institution: Arbeitsgemeinschaft Lungensport in Deutschland e.V.

Literatur

  • 1 Fabel H, Konietzko N. eds .Weißbuch Lunge 2005. Stuttgart: Thieme 2005
    Google Scholar
  • 2 http://www.copd.versorgungsleitlinie.de
  • 3 Murray C, Lopez A. Global mortality, disability, and the contribution to risk factors: Global Burden of Disease Study.  Lancet. 1997;  349 1436-1442
    CrossrefPubMedGoogle Scholar
  • 4 Kardos P. et al .Leitlinien zur Diagnostik und Therapie von Asthma. Stuttgart: Thieme 2005
    Google Scholar
  • 5 http://www.ginasthma.com. Global Initiative for Asthma, U.O. Zitat. 
    Google Scholar
  • 6 Worth H. et al . Leitlinie der Deutschen Atemwegsliga und der Deutschen Gesellschaft für Pneumologie zur Diagnostik und Therapie von Patienten mit chronisch obstruktiver Bronchitis und Lungenemphysem (COPD).  Pneumologie. 2002;  56 704-738
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 GOLD Global Initiative for Chronic Obstructive Pulmonary Disease .Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBL WHO Workshop Report. Executive Summary. National Institue of Health/National Heart, Lung, and Blood Institute 2005, Zitat
    Google Scholar
  • 8 Ram F, Robinson S, Black P. Effects of physical training in asthma: a systematic review.  Br J Sports Med. 2000;  34 162-167
    CrossrefPubMedGoogle Scholar
  • 9 Lacasse Y. et al .Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev, CD003793 2002
    Google Scholar
  • 10 Griffiths T. et al . Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial.  Lancet. 2000;  355 (9201) 362-368
    CrossrefPubMedGoogle Scholar
  • 11 Behnke M. et al . Clinical benefits of a combined hospital and home-based exercise programme over 18 months in patients with severe COPD.  Monaldi Arch Chest Dis. 2003;  59 (1) 44-51
    PubMedGoogle Scholar
  • 12 Göhl O. Effekte eines ambulanten wohnortnahen Rehabilitationsprogramms für Patienten mit COPD. Berlin: Lehmanns Media - LOB.de 2003
    Google Scholar
  • 13 Mikkelsen R. et al . Anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). A review.  Nord J Psychiatry. 2004;  58 (1) 65-70
    CrossrefPubMedGoogle Scholar
  • 14 Rahmenvereinbarung über den Rehabilitationssport und das Funktionstraining vom 1. Oktober 2003. Zitat
    Google Scholar
  • 15 Göhl O. Grundlagen der Trainingstherapie bei COPD.  Atemw-Lungenkrkh. 2005;  31 501-509
    PubMedGoogle Scholar
  • 16 Worth H, Meyer A, Folgering H. et al . Empfehlungen der Deutschen Atemwegsliga zum Sport und körperlichen Training bei Patienten mit obstruktiven Atemwegserkrankungen.  Pneumologie. 2000;  54 61-67
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 ATS statement .Guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002 166 (1): 111-117
    Google Scholar
  • 18 Wassermann K. et al .Principles of Exercise Testing and Interpretation (3rd ed.). Lippincott: Williams & Wilkins 1999
    Google Scholar
  • 19 Borg G. Psychophysical bases of perceived exertion.  Med Sci Sports Exerc. 1982;  14 377-381
    PubMedGoogle Scholar
  • 20 Müller C, Jacob S. Sporttherapie bei obstruktiven Atemwegserkrankungen. Großhansdorf: Inter-Pneu-Verlag 2005
    Google Scholar
  • 21 Hollmann W, Hettinger T. Sportmedizin. Stuttgart, New York: Schattauer 2000
    Google Scholar
  • 22 Weineck J. Optimales Training: Leistungsphysiologische Trainingslehre unter besonderer Berücksichtigung des Kinder- und Jugendtrainings. 13 ed. Balingen: Spitta-Verlag 2003
    Google Scholar
  • 23 American College of Sports Medicine . Position Stand on Progression Models in Resistance Training for Healthy Adults.  Med Sci Sports Exerc. 2002;  34 364-380
    PubMedGoogle Scholar
  • 24 American College of Sports Medicine . American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults.  Med Sci Sports Exerc. 1998;  30 975-991
    PubMedGoogle Scholar
  • 25 Feigenbaum M, Pollock M. Prescription of resistance training for health and disease.  Med Sci Sports Exerc. 1999;  31 38-45
    PubMedGoogle Scholar
  • 26 American Association of Cardiovascular and Pulmonary Rehabilitation .Guidelines for Cardiac Rehabilitation Programs. 2nd Ed. Champaign, IL: Human Kinetics Publishers 1995: 27-56
    Google Scholar
  • 27 American College of Sports Medicine . Position Stand: Exercise and Hypertension.  Med Sci Sports Exerc. 2004;  36 533-553
    CrossrefPubMedGoogle Scholar
  • 28 American College of Sports Medicine . ACSM position stand on osteoporosis and exercise.  Med Sci Sports Exerc. 1995;  27 i-vii
    PubMedGoogle Scholar
  • 29 American College of Sports Medicine . Position Stand: Exercise for patients with coronary artery disease.  Med Sci Sports Exerc. 1994;  26 i-v
    PubMedGoogle Scholar
  • 30 American College of Sports Medicine . Position Stand: Physical activity, physical fitness, and hypertension.  Med Sci Sports Exerc. 1993;  25 i-x
    PubMedGoogle Scholar
  • 31 American College of Sports Medicine . Exercise and Physical Activity for Older Adults.  Med Sci Sports Exerc. 1998;  30 992-1008
    PubMedGoogle Scholar
  • 32 Pate R. et al . Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine.  JAMA. 1995;  273 402-407
    Google Scholar
  • 33 NIH Consensus Conference . Physical activity and cardiovascular health.  JAMA. 1996;  276 241-246
    CrossrefPubMedGoogle Scholar
  • 34 Fletcher G. et al . Statement on exercise: benefits and recommendation for physical activity programs for all Americans. A statement for health professionals by the committee on exercise and cardiac rehabilitation of the council on clinical cardiology, American Heart Association.  Circulation. 1996;  94 857-862
    CrossrefPubMedGoogle Scholar
  • 35 U.S. Department of Health and Human Services .Physical Activity and Health: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; National Center for Chronic Dosease Prevention and Health Promotion 1996
    Google Scholar
  • 36 Gettman L. et al . Physiologic responses of men to 1, 3 and 5 day per week training programs.  Res Q. 1976;  47 638-646
    PubMedGoogle Scholar
  • 37 Pollock M. The quantification of endurance training programs. In: Wilmore J (ed.). Exercise and Sport Sciences Reviews. New York: Academic Press 1973: 155-188
    Google Scholar
  • 38 Wenger H, Bell G. The interactions of intensity, frequency, and duration of exercise training in altering cardiorespiratory fitness.  Sports Med. 1986;  3 346-356
    CrossrefPubMedGoogle Scholar
  • 39 Nici L. et al . American Thoracic Society/European Respiratory Society Statement on Pulmonary Rehabilitation.  Am J Respir Crit Care Med. 2006;  173 1390-1413
    CrossrefPubMedGoogle Scholar
  • 40 Hickson R, Rosenkoeter M. Reduced training frequences and maintenance of increased aerobic power.  Med Sci Sports Exerc. 1981;  13 13-16
    PubMedGoogle Scholar
  • 41 Hickson R. et al . Reduced training duration effects on aerobic power, endurance and cardiac growth.  J Appl Physiol. 1982;  53 225-229
    PubMedGoogle Scholar
  • 42 Hickson R. et al . Reduced training intensities and loss of aerobic power, endurance, and cardiac growth.  J Appl Physiol. 1985;  58 492-499
    PubMedGoogle Scholar
  • 43 Martin W. et al . Cardiovascular adaptions to intense swim training in sedentary middle-aged men and women.  Circulation. 1987;  75 323-330
    PubMedGoogle Scholar
  • 44 Blair S, Kohl H, Goodyear N. Rates and risks for running and exercise injuries: studies in three populations.  Res Q Exerc Sports. 1987;  58 221-228
    PubMedGoogle Scholar
  • 45 Pollock M. et al . Effects of frequency and duration of training on attrition and incidence of injury.  Med Sci Sports. 1977;  9 31-36
    PubMedGoogle Scholar
  • 46 Hernandez M. et al . Results of a home-based training program for patients with COPD.  Chest. 2000;  118 (1) 106-114
    CrossrefPubMedGoogle Scholar
  • 47 Haskell W. Physical activity and health: need to define the required stimulus.  Am J Cardiol. 1985;  55 4D-9D
    CrossrefPubMedGoogle Scholar
  • 48 Haskell W, Montoye H, Orenstein D. Physical activity and exercise to achieve health-related physical fitness components.  Public Health Rep. 1985;  100 202-212
    PubMedGoogle Scholar
  • 49 Laporte R. et al . The spectrum of physical activity, cardiovascular disease and health: an epidemiologic perspective.  Am J Epidemiol. 1984;  120 507-517
    PubMedGoogle Scholar
  • 50 Paffenbarger R. et al . Physical activity and all-cause mortality, and longlivety of college alumni.  N Engl J Med. 1986;  314 605-613
    CrossrefPubMedGoogle Scholar
  • 51 Vogiatzis I. et al . Physiological response to moderate exercise workloads in a pulmonary rehabilitation program in patients with varying degrees of airflow obstruction.  Chest. 1999;  116 (5) 1200-1207
    CrossrefPubMedGoogle Scholar
  • 52 Hui K, Hewitt A. A simple pulmonary rehabilitation program improves health outcomes and reduces hospital utilization in patients with COPD.  Chest. 2003;  124 (1) 94-97
    CrossrefPubMedGoogle Scholar
  • 53 Ries A. et al . Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease.  Ann Intern Med. 1995;  122 (11) 823-832
    CrossrefPubMedGoogle Scholar
  • 54 Zintl F, Eisenhut A. Ausdauertraining. Grundlagen - Methoden - Trainingssteuerung. München-Wien-Zürich: BLV Verlagsgesellschaft mbH 2001
    Google Scholar
  • 55 Casaburi R. Skeletal muscle function in COPD.  Chest. 2000;  117 (5 Suppl 1) 267S-271S
    CrossrefPubMedGoogle Scholar
  • 56 Casaburi R. et al . Physiologic benefits of exercise training in rehabilitation of patients with severe chronic obstructive pulmonary disease.  Am J Respir Crit Care Med. 1997;  155 (5) 1541-1551
    PubMedGoogle Scholar
  • 57 Debusk R. et al . Training effects of long versus short bouts of exercise in healthy subjects.  Am J Cardiol. 1990;  65 1010-1013
    CrossrefPubMedGoogle Scholar
  • 58 Ebisu T. Splitting the distance of endurance training: effects on cardiovascular endurance and blood lipids.  Jpn J Physiol Educ. 1985;  30 37-43
    PubMedGoogle Scholar
  • 59 Jakicic J. et al . Prescribing exercise in multiple short bouts versus one continous bout: effect of adherence, cardiorespiratory fitness, and weight loss in overweight women.  Int J Obes. 1995;  19 893-901
    PubMedGoogle Scholar
  • 60 Casaburi R. et al . Reductions in exercise lactic acidosis and ventilation as a result of exercise training in patients with obstructive lung disease.  Am Rev Respir Dis. 1991;  143 (1) 9-18
    CrossrefPubMedGoogle Scholar
  • 61 Vogiatzis I, Nanas S, Roussos C. Interval training as an alternative modality to continuous exercise in patients with COPD.  Eur Respir J. 2002;  20 (1) 12-9
    CrossrefPubMedGoogle Scholar
  • 62 Gosselink R, Troosters T, Decramer M. Exercise training in COPD patients: interval versus endurance training.  Eur Respir J. 1998;  12 2s
    PubMedGoogle Scholar
  • 63 Pleyer K, Weber M, Schmitz M. Wann Dauer- und wann Intervallmethode? Zur Trainierbarkeit von Patienten mit obstruktiven Atemwegserkrankungen.  Z f Physiotherapie. 2001;  53 7
    PubMedGoogle Scholar
  • 64 Vogiatzis I. et al . Dynamic hyperinflation and tolerance to inteval exercise in patients with advanced COPD.  Eur Respir J. 2004;  24 385-390
    Google Scholar
  • 65 Siskovick D. et al . The incidence of primary cardiac arrest during vigorous exercise.  N Engl J Med. 1984;  311 874-877
    CrossrefPubMedGoogle Scholar
  • 66 Pollock M. Prescribing exercise for fitness and adherence. In: Dishman R (ed.). Exercise Adherence: Its Impact on Public Health Champaign, IL: Human Kinetics Books 1988: 259-277
    Google Scholar
  • 67 Pollock M, Wilmore J. Exercise in Health and Disease: Evaluation and Prescription for Prevention and Rehabilitation. 2nd Ed. Philadelphia: WB Saunders 1990: 91-160
    Google Scholar
  • 68 Dishman R, Sallis J, Orenstein D. The determinants of physical activity and exercise.  Public Health Rep. 1985;  100 158-180
    PubMedGoogle Scholar
  • 69 Martin J, Dubbert P. Adherence to exercise. In: Terjung R (ed.). Exercise and Sport Sciences Reviews. New York: MacMillan 1985: 137-167
    Google Scholar
  • 70 Salis J. et al . Predictors of adoption and maintenance of physical activity in a community sample.  Prev Med. 1986;  15 131-141
    PubMedGoogle Scholar
  • 71 Rochester C. Exercise training in chronic obstructive pulmonary disease.  J Rehabil Res Dev. 2003;  40 (5 Suppl 2) 59-80
    PubMedGoogle Scholar
  • 72 Puhan M A. et al . How should COPD patients exercise during respiratory rehabilitation? Comparison of exercise modalities and intensities to treat skeletal muscle dysfunction.  Thorax. 2005;  60 (5) 367-375
    CrossrefPubMedGoogle Scholar
  • 73 Storer T. Exercise in chronic obstructive pulmonary disease: resistance exercise prescription.  Med Sci Sports Exerc. 2001;  33 S680-686
    PubMedGoogle Scholar
  • 74 Wright P. et al . Einfluss eines Krafttrainings auf Lungenfunktionsparameter und Größen der Leistungsfähigkeit von COPD-Patienten.  Pneumologie. 2002;  56 413-417
    Article in Thieme ConnectPubMedGoogle Scholar
  • 75 O'Shea S D, Taylor N F, Paratz J. Peripheral muscle strength training in COPD: a systematic review.  Chest. 2004;  126 (3) 903-914
    CrossrefPubMedGoogle Scholar
  • 76 Lecheler J, Biberger A, Pfannebecker B. Asthma und Sport. Berchtesgaden: INA-Verlag 2006
    Google Scholar
  • 77 http://www.Lungensport.org

1 Durchführende Institution: Arbeitsgemeinschaft Lungensport in Deutschland e.V.

Dr. phil. Oliver Göhl, Sportwissenschaftler, Sporttherapeut

Klinikum Fürth, Med. I

Jakob-Henle-Str. 1

90533 Fürth

Email: oliver.goehl@klinikum-fuerth.de

      >