Effects of Intermittent Hypoxic Training on Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease

  • Martin BurtscherEmail author


Intermittent hypoxic training (IHT) has been suggested to increase exercise tolerance in patients with cardiovascular disease by enhancing stress resistance and/or improving oxygen delivery. This is also assumed to be true for patients with chronic obstructive pulmonary disease (COPD). This chapter discusses findings, derived from randomized controlled studies, on the effects of IHT on exercise tolerance in patients suffering from mild COPD. Three weeks of IHT increased total haemoglobin mass (+4% vs. 0%, P < 0.05), total exercise time (+9.7% vs. 0%, P < 0.05) and the exercise time to the anaerobic threshold (+13% vs. −7.8%, P < 0.05) compared to controls. Changes in the total exercise time were positively related to the changes in total haemoglobin mass (r = 0.59, P < 0.05), and changes in the time to the anaerobic threshold were positively related to the changes in the lung diffusion capacity for carbon monoxide (DLCO) (r = 0.48, P < 0.05). Increases in vagal activity after IHT were related to the reduced values of heart rate and blood lactate concentration observed during submaximal exercise (6-min walk test), and changes in respiratory pattern after IHT were related to the lower ventilatory equivalents for oxygen and carbon dioxide (V E/VO2 and V E/VCO2) at the anaerobic threshold determined by incremental cycle ergometry. In conclusion, IHT can improve exercise tolerance in patients with mild COPD. IHT is considered as repeated stress training and subsequent adaptations resulting in corrections of impaired DLCO, improved ventilatory efficiency, enhancement of total haemoglobin mass and changes of the autonomic balance to higher vagal and lower sympathetic activity. Thus, IHT may be a valuable tool to complement the known beneficial effects of exercise training in patients with COPD.


Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Patient Exercise Tolerance Obstructive Sleep Apnoea Anaerobic Threshold 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Anaerobic threshold


End-tidal CO2


Chronic obstructive pulmonary disease


Lung diffusion capacity for carbon monoxide


Forced expiratory volume in 1 s


Forced expiratory vital capacity


Inspiratory fraction of oxygen


Hypercapnic ventilatory response


Hypoxia-inducible factor


Heart rate


Hypoxic ventilatory response


Intermittent hypoxia


Intermittent hypoxic training


Nitric oxide


Obstructive sleep apnoea


Ratings of perceived exertion


Arterial oxygen saturation


Standard deviation


Minute ventilation


Oxygen uptake


Ventilatory equivalent for oxygen


Ventilatory equivalent for carbon dioxide


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Copyright information

© Springer-Verlag London 2012

Authors and Affiliations

  1. 1.Department of Sport Science, Medical SectionUniversity of InnsbruckInnsbruckAustria

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