Physical activity in COPD – can 6-second intervals help?

2026 NLC Reykjavik

Fysisk aktivitet och lungrehabilitering

DELA MED SIG

Pulmonary rehabilitation is a cornerstone in COPD care. It is a non-pharmacological multicomponent approach that decreases dyspnoea and improves physical capacity for persons living with COPD. Recent research demonstrated the feasibility and safety of supramaximal HIIT in the COPD population, with fewer interruptions due to breathlessness compared to continuous exercise.

Aiming for less dyspnoea and better physical capacity

Pulmonary rehabilitation is a crucial, multidisciplinary intervention for individuals with COPD, aiming to reduce breathlessness and enhance physical capacity. Traditional exercise programmes often rely on prolonged, continuous activity, but high-intensity interval training (HIIT) has shown promise for enabling COPD patients to exercise at higher intensities without being limited by minute ventilation. Ongoing studies are investigating the long-term effects of HIIT on physical, cognitive, and neurological outcomes in COPD.

Minute ventilation is a limiting factor

Exercise programs for persons with COPD is often constructed with prolonged periods of continuous exercise. Recommendations for physical activity does not differ between COPD and the general population.²

However, as minute ventilation is often a limiting factor in the COPD population: the activity can only be sustained at a very low intensity, otherwise it has to be discontinued due to intolerable breathlessness. As a result, the training volume is insufficient for creating optimal peripheral physiological adaptations.

Super-maxxing the intensity

Professor André Nyberg from Umeå and his research group has in the past years directed their attention to High-Intensity Interval Training (HIIT) and explored applying this approach in COPD. With this type of exercise training, persons with COPD can exercise at very high intensities without being restricted by the minute ventilation. In a randomized crossover trial, they studied the feasibility and effect of an acute bout of exercise on a supramaximal intensity in a mild-to-moderate COPD population, compared to continuous exercise.³ The 10 HIIT-bouts consisted of 6 seconds exercise at 150% of maximal aerobic power, followed by a 54 second recovery.  They found that all the participants completed the ”SupraHIIT” session with no adverse events, while 5 of 16 participants interrupted the continuous exercise bout due to dyspnoea or exhaustion. These results support the feasibility of extremely high intensity exercise in this population and a superior success rate compared to regular continuous exercise.

What about long-term effects?

Next step is to investigate the long-term effects of SupraHIIT training in COPD. André revealed the study design of a 24-month trial where one group is randomized to HIIT, and another group is randomized to continuous exercise. They will look into impact on cognitive function, cardiorespiratory fitness and muscle power following a supramaximal HIIT intervention.

A multidisciplinary approach to COPD is needed

For a physician with limited experience of exercise training, this type of exercise might sound difficult to perform or tough for patients. However, André pointed out that this is a basic training protocol for physiotherapists, exercise physiologist or any individual trained in sports science. Managing COPD is a heterogeneous disease requiring a multidisciplinary approach.

Collaboration with physiotherapists may help integrate HIIT as a key component of pulmonary rehabilitation programmes. Reach out to the physiotherapist at your hospital or clinic and discuss the possibility to improve the pulmonary rehabilitation program for COPD patients. HIIT could be included as key component.

Emil Bojsen-Møller
Medical Advisor, Chiesi Nordic

ID 22695-12.06.2026