ABSTRACT
Chronic obstructive pulmonary disease (COPD) is a disease state characterized by a
progressive airflow limitation that is partly reversible after optimal pharmacological
treatment (1). Although the pulmonary dysfunction may explain to a certain extent
the degree of severity of each day’s symptoms of dyspnea and fatigue (2), it does not
appear to be the foremost determining factor of exercise tolerance (3), survival (4-7),
disease-specific quality of life (8), hospital readmission rate (9), and daily physical
activity level (10) in COPD patients. Indeed, abnormal loss of body weight and fat-free
mass, physical deconditioning, and the level of dyspnea during everyday life appear to
be stronger determinants of the aforementioned clinically relevant outcomes (4-7,11).
These observations provide a clear rationale to start a comprehensive interdisciplinary
pulmonary rehabilitation in patients with COPD, irrespective of the degree of airway
obstruction (12,13). In fact, it validates the worldwide attention that pulmonary
rehabilitation has received in the past 15 years.
