Is Exercise Important in Chronic Obstructive Pulmonary Disease?

Figures & data

Table 1 Concepts embodied by the term “exercise” as viewed by different participants in the medical system

Healthy individuals

Recreational activity

Enjoyable activity

Health-promoting regular activity

Patients with COPD

Strenuous

Unsatisfying

Physicians and other health-care providers

Health-promoting strenuous regular physical activity

Pulmonary rehabilitation

Table 2 Potential outcomes of therapy in patients with COPD

Patient-Reported Outcomes

Respiratory symptoms

Quality of life

Activities performed during daily life

Functional Capacity

Respiratory function – pulmonary function

Physical function – capacity for physical activity

Neuropsychological function

Disease Course

Exacerbations

Mortality

Disease

Pathophysiology

Pathology

Radiology

Other

Health-care utilization – hospitalization

Medications/therapies

Adverse effects

Healthy behaviors

Satisfaction (with therapy)

Costs (direct, indirect)

Caregiver burden

Physical appearance

Assistive technology use

Figure 1 Heuristic relationship between physical activity and functional performance on the vertical axis and functional capacity on the horizontal axis. As functional capacity (exercise capacity) measured by exercise testing falls to lower levels, there is a more rapid decline in an individual's functional performance and physical activity. Physical activity can be classified functionally as activities of daily living (ADL) that are basic (required for self-care of one's body such as eating and toileting), instrumental (required to live independently such as food preparation), or extended (social and recreational).

Figure 2 Lung dysfunction in COPD results in shortness of breath and reduced exercise capacity. Symptomatic maximal exercise limitation is associated with reduced physical activity and impaired quality of life, along with depression and anxiety.