ABSTRACT
Chronic obstructive pulmonary disease (COPD) refers to a collection of lung diseases, including chronic bronchitis, emphysema and chronic obstructive airways disease. Mortality and morbidity are high in people with COPD and severe disabling symptoms are common. These include distressed breathing, limited exercise tolerance and frequent exacerbations. Anxiety and depression are other common symptoms of COPD and may be exacerbated by sleep disturbances and dyspnoea. Exercise is crucial in the management of COPD as a way of breaking the spiral of inactivity associated with dyspnoea. Lung impairment leads to breathlessness during exertion, fear and avoidance of activities which leads to deconditioning of skeletal muscles, greater dyspnoea and increasing inactivity. COPD is a progressive disease, with lung impairment further declining over time and there are few disease modifying treatments available (Hanania et al., 2005). In a synergistic manner inactivity, dyspnoea and lung impairment interact to cause significant systemic consequences for people with COPD (Agusti, 2005). It is only in the last decade that health professionals have begun to fully appreciate the extent of the problems experienced as a result of COPD, including increased fatigue (Lewko et al., 2009), difficulty performing tasks of daily activity and dyspnoea. Other clinical manifestations include an increased risk of osteoporosis (Graat-Verboom et al., 2009), diabetes, carcinomas (Turner et al., 2007), cardiovascular co-morbidity and alterations in body, both high and low, mass index (Barnes and Celli, 2009).
