Search

In 2014, we were proud to launch the European Respiratory Society (ERS)/European Lung Foundation (ELF) campaign: Healthy Lungs for Life (HLfL; www.healthylungsforlife.org); a lung health campaign to educate all stakeholders about the importance of prevention and management of lung disease and how this can be achieved. Our inaugural theme, “Breathe Clean Air”, was a timely and impactful topic to kick off with and resonated across the globe with politicians in the EU, journalists in a range of countries, scientists carrying out research with funding from HLfL, the people of Munich who had their lungs tested while the ERS International Congress took place, and those who attended events held by our collaborators across the globe, from India to the USA to New Zealand., ERS/ELF say “take the active option” for Healthy Lungs for Life http://ow.ly/R1WaX

The mission of ERS is to alleviate suffering from respiratory disease and to promote lung health through research, sharing of knowledge and through medical and public education. Within this context, respiratory physiotherapy plays a fundamental role in improving ventilation, and enhancing quality of life [1] for patients with respiratory disease. Physiotherapists work with patients in a variety of settings including patients' homes, pulmonary rehabilitation programmes, wards and intensive care units. Although physiotherapy is globally recognised within the healthcare profession, some respiratory physiotherapy techniques have been clouded by a lack of scientific evidence [2] and insufficient clinical data [3] on the benefits of specific techniques in the treatment of patients suffering from respiratory disease. In recent decades, evidence (or absence thereof) has been emerging for many techniques related to exercise training, mucus transport and breathing retraining strategies. The field is rapidly evolving. In 1995 a specific group involving respiratory physiotherapists was established. This active group exists under the European Respiratory Society assembly for allied health professionals (ERS group 9.02), and gathers annually during the ERS Annual Congress, keeping an open channel of communication with physiotherapists throughout the year. Stiller [3] reported that while “some physiotherapists routinely treat most if not all ICU patients with a combination of techniques, […] other physiotherapists use such techniques selectively when they believe they are specifically indicated”, thereby highlighting the differences in treatment of patients by respiratory physiotherapists just over a decade ago. In 2009, Bott et al. [2] published guidelines with the distinct purpose of producing evidence-based recommendations for practice. In recent years, great strides have been taken in research of respiratory physiotherapy to accumulate and report on the supporting rationale and effectiveness of respiratory physiotherapy techniques and combinations of techniques used in …

Key points An exercise test should be performed: if there is impaired exercise tolerance; to find out which system is limiting exercise; to establish which organ systems have an abnormal response during or after exercise; to investigate how much exercise is appropriate/safe in a patient; and to determine the response to treatment. Prediction of exercise performance based solely on resting pulmonary function tests is inaccurate. The gold standard in exercise testing is the incremental exercise test. Two types of ergometers can be selected for incremental exercise testing: a treadmill or a cycle ergometer. More muscle mass is put to work using a treadmill when compared with cycling. Incremental exercise testing and field testing have complementary value in, for example, pulmonary rehabilitation. Exercise laboratories should be encouraged to test some healthy control subjects in the age span of interest to evaluate which normal values best suit their laboratory setting. Educational aims To address some questions that often arise when exercise testing is performed in the clinical routine: What are the indications to perform an exercise test? Which test should be used for which situation? How should the test be carried out in practice? How should the results of the test be interpreted? Summary Exercise testing is widely applied in clinical practice. The aim of this article is to address some questions that often arise when exercise testing is performed in clinical routine. Two complementary tests will be discussed in more detail: the maximal incremental ergometer test and the timed walk test. First, the indication to perform exercise testing is discussed. The second question is which test to apply and how to carry out the test in practice. Finally, the interpretation of the results of the tests are discussed.