Common impairments experienced by patients with myopathy include muscle weakness, reduced endurance and cardiovascular fitness. Strength-training programmes, incorporating isometric, isotonic or isokinetic exercise, have been shown to improve muscle strength in the short term, without evidence of increased muscle damage using biochemical markers. However, there is some evidence that eccentric exercise may have adverse effects in patients with myopathy, Aerobic training programmes using cycle ergometers or treadmills have demonstrated an improvement in cardiovascular fitness, muscle strength and endurance, again without evidence of increased muscle damage. Further research is needed to determine the optimum training protocols for patients with various types of myopathy, and in particular to improve the ability of patients to be active and independent in daily life, Curr Opin Neurol 13:547-552. (C) 2000 Lippincott Williams & Wilkins.