Introduction ............................................................................................................ 182 Rationale for Progressive Resistance Training ...................................................... 182 Evidence That Progressive Resistance Training Is Benecial for Individuals with COPD ............................................................................................................. 182 Summary of Outcomes for Systematic Review Update ......................................... 183

Program Content and Environmental Factors ................................................... 184 Personal Factors ................................................................................................ 184 Body Structure and Function ............................................................................ 192

Muscle Function (Strength) .......................................................................... 192 Body Composition ........................................................................................ 192 Respiratory Function, Maximal Exercise Capacity, and Psychological Function ........................................................................................................ 192 Dyspnea ........................................................................................................ 193

Activity .............................................................................................................. 194 Participation ...................................................................................................... 194 Long-Term Outcomes of Progressive Resistance Exercise ............................... 194

Synthesis of Evidence for Progressive Resistance Training for Individuals with COPD ............................................................................................................. 195 Implementing Progressive Resistance Training in the Clinical Setting ................. 197

Who Is Suitable? ............................................................................................... 197 What Equipment? .............................................................................................. 198 What Exercises? ................................................................................................ 198 Special Consideration-Continence .................................................................200 What Setting? .................................................................................................... 201 Monitoring Progress .......................................................................................... 201 Adherence to Progressive Resistance Training .................................................202

Conclusions ............................................................................................................203 References ..............................................................................................................203

Chronic obstructive pulmonary disease (COPD) is characterized by ongoing and predominantly irreversible airow limitation that is associated with chronic inammatory responses in the airways. As the disease progresses, chronic inammation leads to thickening of airway walls and pulmonary vasculature, as well as destruction of lung parenchyma.1 Changes in pulmonary structure and function are associated with common symptoms such as dyspnea (shortness of breath), chronic cough with or without sputum production, wheeze, fatigue, as well as reduced exercise tolerance.1