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The disease not only impacts the physical well being of the patient, but also poses a burden to the emotional, economic and social aspects of both the patient and the family members (Fromer and Cooper, 2008). The condition is associated with significant morbidity and mortality and affects the quality of life of the patient. COPD cannot be cured, but timely and appropriate treatment can significantly reduce the severity and duration of symptoms, thereby increasing the quality of life and decreasing morbidity and mortality (GOLD, 2008). The main problem in COPD is breathlessness. Several strategies have been developed to minimize these symptoms in COPD, the most important of which is pulmonary rehabilitation. Evidence-based analyses from several randomized controlled trials have proved that exercise training is critical for improvement of not only the exercise capacity of the patients, but also their quality of life (Yohannes and Connolly, 2004). There are basically two types of exercise training and they are continuous training and intermittent training. Both types of training have been used for the management of chronic breathlessness in COPD. However, which of the two is better is a much debated topic. In this literature review, studies comparing the two methods of exercise training will be reviewed to ascertain as to which is a better strategy for prevention and management of breathlessness in COPD patients.
Chronic obstructive pulmonary disease or COPD may be defined as "a disease state characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema" (Sharma, 2006). Clinically, the diagnosis of chronic bronchitis is made when there is chronic productive cough without any other specific etiology for more than 3 months, and emphysema is diagnosed when there is irreversible damage to air spaces beyond terminal bronchioles, with no obvious fibrosis (Fromer and Cooper, 2008). According to NICE (2004), "diagnosis
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