TY - JOUR T1 - Exercise training and pulmonary rehabilitation: new insights and remaining challenges JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW SP - 24 LP - 29 DO - 10.1183/09059180.00007809 VL - 19 IS - 115 AU - T. Troosters AU - R. Gosselink AU - W. Janssens AU - M. Decramer Y1 - 2010/03/01 UR - http://err.ersjournals.com/content/19/115/24.abstract N2 - Pulmonary rehabilitation is now regarded as an evidence-based treatment for symptomatic patients with chronic obstructive pulmonary disease. It has been shown to enhance exercise tolerance, improve symptoms and health-related quality of life, and reduce exacerbations in patients with recurrent exacerbations. In this article we review the mechanisms through which exercise training results in beneficial effects. We also review three challenges that currently remain: 1) the fine tuning of exercise training and multidisciplinary programmes; 2) the timing of rehabilitation; and 3) efforts to enhance the accessibility and adherence to pulmonary rehabilitation programmes. Further research is needed in order to apply the now well-established principles of pulmonary rehabilitation to unusual patient populations, or patient populations that are unlikely to participate in conventional outpatient programmes. ER -