# The Effect of High-Intensity Interval Training on Exercise Tolerance in Patients with Respiratory Diseases > Impact of HIIT on Exercise Capacity in People with Respiratory Diseases. ## Introduction Evidence-Based Physical Therapy (EBP) uses the best research evidence with clinical expertise and user’s preferences to produce the most appropriate and effective care. In week 44 of 2025, an international course on EBP was held at the Faculty of Physiotherapy at the University of A Coruña, Spain. The program was organized by The European Network of Physiotherapy in Higher Education (ENPHE). More than 30 physiotherapy students and 9 teachers from six universities (Savonia University of Applied Sciences, Finland; Universidade da Coruña, Spain; Charles University, Czech Republic; CERRFF and École D´Assas, France; and Escola de Santa María de O Porto, Portugal) participated in the week. Students collaborated on articles covering evidence-based neurology, respiratory and musculoskeletal disorders, geriatric and pediatric care, and sports injuries. This article presents the work of the respiratory group. ## Background Chronic respiratory diseases such as COPD, asthma, and post-COVID-19 conditions are among the main causes of physical disability and reduced quality of life worldwide. Rehabilitation and physical activity are essential for improving respiratory function and exercise capacity. While recent studies confirm that exercise training improves tolerance to physical effort, the most effective type of program remains under discussion. High-Intensity Interval Training (HIIT) has been proposed as a more efficient method than traditional continuous training, though research protocols vary. ## Methodology The aim of this work was to explore the available evidence regarding the effects of HIIT on exercise tolerance in adults with respiratory diseases and to identify the most effective intervention methods. * **Search Strategy:** We used the PICO system to search for randomized controlled trials (RCTs) published between 2010 and 2025. Databases used included PubMed and PEDro. * **Inclusion Criteria:** Adults with chronic respiratory diseases (COPD, asthma, or post-COVID-19). * **Intervention:** HIIT as part of a rehabilitation program. * **Control:** Moderate-intensity continuous training, modified exercise protocols (e.g., supplemental oxygen), usual care, or no training. * **Quality Assessment:** The methodological quality of included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale, an 11-item tool evaluating internal validity and interpretability. ## Results Four studies were included in the review: * **Türk et al. (2020):** Obese patients with asthma participating in short-term HIIT showed greater improvement in the 6-minute walk test and quality of life compared to the control group. * **Neunhäuserer et al. (2021):** Patients with COPD training with HIIT plus supplemental oxygen showed the greatest improvements in endurance and lung function compared to regular training. * **Rasmussen et al. (2023):** People recovering from COVID-19 who followed a 12-week HIIT program showed improved heart function and exercise capacity compared to a moderate training group. * **Batajrobeh et al. (2021):** Miners with COPD showed improvements in both HIIT and moderate-intensity groups, but the HIIT group achieved larger gains in breathing tests and walking distance. ## Discussion and Conclusion The reviewed studies consistently demonstrate that HIIT has positive effects on exercise tolerance and cardiopulmonary function in patients with chronic respiratory diseases. HIIT often produces faster and more noticeable improvements than moderate, continuous exercise. While variability in training protocols (intensity, duration, frequency) limits direct comparison, HIIT appears to be a safe, feasible, and time-efficient rehabilitation method. Future research should focus on standardizing HIIT protocols, unifying measurement tools, and evaluating long-term outcomes such as adherence and relapse prevention. ## Authors * **Milla Saastamoinen**, Bachelor’s degree student, Physiotherapy, Savonia University of Applied Sciences, Finland. * **Renáta Šimoníčková**, Bachelor’s degree student, Physiotherapy, Charles University, Czech Republic. * **Leo Vandamme**, Bachelor’s degree student, Physiotherapy, Charles University, Czech Republic. * **Juliette Duault**, Bachelor’s degree student, Physiotherapy, CEERRF, France. * **Dagmar Pavlu**, PT, Assoc. Prof., Charles University, Czech Republic. * **Ivana Vláčilová**, PhD, PT, Charles University, Czech Republic. * **Marja Äijö**, PT, PhD, Principal Lecturer of gerontology and rehabilitation, Savonia University of Applied Sciences, Finland. * **Veronica Robles García**, PhD, PT, OT, Associate Professor, University of A Coruña, Spain. * **Zeltia Naia Entonado**, PhD, PT, University of A Coruña, Spain. * **María Vilanova Pereira**, PhD, PT, University of A Coruña, Spain. * **Adrien Pallot**, PT, MSc, Lecturer at École D´Assas, France. * **Aurel Bellaïche**, PT, Lecturer at CEERRF, France. ## References * Ahmed, I., Mustafaoglu, R., Yeldan, İ., Yasaci, Z., & Erhan, B. (2022). Effect of pulmonary rehabilitation approaches on dyspnea, exercise capacity, fatigue, lung functions, and quality of life in patients with COVID‑19: A systematic review and meta‑analysis. *Archives of Physical Medicine and Rehabilitation*, 103(10), 2051–2062. https://doi.org/10.1016/j.apmr.2022.06.007 * Batajrobeh, A., Ahmadi, M. M., & Mogharnasi, M. (2021). Effects of High and Moderate-Intensity Interval Training on Pulmonary and Performance Parameters in Miners Suffering From Chronic Obstructive Pulmonary Diseases. *Journal of occupational and environmental medicine*, 63(10), e673–e678. https://doi.org/10.1097/JOM.0000000000002329 * Global Burden of Chronic Respiratory Diseases Collaborators. (2023). Updated estimates on the global burden of chronic respiratory diseases and their risk factors, 1990–2019. *eClinicalMedicine*, 59, 101936. https://doi.org/10.1016/j.eclinm.2023.101936 * Martínez‑Pozas, O., Meléndez‑Oliva, E., Martínez Rolando, L., Quesada Rico, J. A., Corbellini, C., & Sánchez Romero, E. A. (2024). The pulmonary rehabilitation effect on long COVID‑19 syndrome: A systematic review and meta‑analysis. *Physiotherapy Research International*, 29(2), e2077. https://doi.org/10.1002/pri.2077 * Neunhäuserer, D., Reich, B., Mayr, B., Kaiser, B., Lamprecht, B., Niederseer, D., Ermolao, A., Studnicka, M., & Niebauer, J. (2021). Impact of exercise training and supplemental oxygen on submaximal exercise performance in patients with COPD. *Scandinavian journal of medicine & science in sports*, 31(3), 710–719. https://doi.org/10.1111/sms.13870 * Physiotherapy Evidence Database 2020. PEDro scale. Online publication. Updated 1.9.2025. https://pedro.org.au/english/resources/pedro-scale/ * Rasmussen, I. E., Løk, M., Durrer, C. G., Foged, F., Schelde, V. G., Budde, J. B., Rasmussen, R. S., Høvighoff, E. F., Rasmussen, V., Lyngbæk, M., Jønck, S., Krogh-Madsen, R., Lindegaard, B., Jørgensen, P. G., Køber, L., Vejlstrup, N., Klarlund Pedersen, B., Ried-Larsen, M., Lund, M. A. V., Christensen, R. H., … Berg, R. M. G. (2023). Impact of high-intensity interval training on cardiac structure and function after COVID-19: an investigator-blinded randomized controlled trial. *Journal of applied physiology*, 135(2), 421–435. https://doi.org/10.1152/japplphysiol.00078.2023 * Türk, Y., Theel, W., van Huisstede, A., van de Geijn, G. M., Birnie, E., Hiemstra, P. S., Sont, J. K., Taube, C., & Braunstahl, G. J. (2020). Short-term and long-term effect of a high-intensity pulmonary rehabilitation programme in obese patients with asthma: a randomised controlled trial. *The European respiratory journal*, 56(1), 1901820. https://doi.org/10.1183/13993003.01820-2019