Person with COPD walking towards lung shaped trees, symbolizing COPD recovery and exercise

COPD Exacerbation: How to Reclaim Your Physical Activity

Lena Kashyap in Health & Wellness July 2025 • 4 min read.

"Understanding the factors that influence your activity levels during and after a COPD flare-up can empower you to take control of your recovery and long-term health."

Chronic Obstructive Pulmonary Disease (COPD) is characterized by persistent respiratory symptoms and airflow limitation. Experiencing an exacerbation, or flare-up, of COPD symptoms can significantly disrupt daily life, particularly affecting an individual's ability to stay active. Reduced physical activity during these times is not just a symptom; it can also lead to a decline in overall health and quality of life.

Hospitalization, often required during severe COPD exacerbations, can further contribute to decreased mobility. Older adults, in particular, face a risk of functional decline due to prolonged periods of inactivity. Understanding the factors that influence physical activity levels during and after a COPD exacerbation is crucial for developing targeted strategies to support recovery and promote long-term well-being.

Research is shedding light on the complex interplay of factors that determine how COPD exacerbations affect physical activity. By identifying these determinants, healthcare professionals and individuals with COPD can work together to implement interventions that minimize the negative impact of flare-ups and encourage a return to an active lifestyle.

Key Factors Influencing Physical Activity During COPD Exacerbations

Person with COPD walking towards lung shaped trees, symbolizing COPD recovery and exercise

A recent study published in the International Journal of COPD investigated the changes in physical activity (PA) levels during moderate-to-severe COPD exacerbations requiring emergency department (ED) assessment. The study, which followed a cohort of patients across 16 hospitals, identified several key factors that influence PA levels during these episodes.

The study revealed that common factors associated with changes in PA during hospital admission or seven days after discharge from the ED included lower baseline PA and reduced activity levels within the first 24 hours of evaluation. This highlights the importance of pre-existing activity levels and the immediate impact of the exacerbation on a person's ability to move.

Age and Overall Health: Older individuals and those with poorer health-related quality of life (HRQoL) experienced greater changes in PA.
Living Situation: Patients living alone were also more likely to experience significant changes in activity levels.
Hospital Stay: The length of hospital stay and the use of certain medications, such as anticholinergics or systemic corticosteroids, also played a role in PA changes among hospitalized patients.
Severity of COPD: For patients not admitted to the hospital, baseline FEV1% (a measure of lung function) and dyspnea (shortness of breath) at rest upon ED arrival were significant predictors of change.

These findings suggest that a combination of factors related to the severity of the exacerbation, the individual's overall health status, and the treatment approach contribute to the changes observed in physical activity during and after a COPD flare-up.

Taking Control: Strategies to Reclaim Your Physical Activity

Understanding the determinants of PA changes during COPD exacerbations empowers individuals to take proactive steps in their recovery. While some factors, such as age, are non-modifiable, others can be influenced through targeted interventions and lifestyle adjustments. By focusing on maintaining baseline fitness, managing symptoms effectively, and working closely with healthcare professionals, people with COPD can minimize the impact of exacerbations and strive for an active, fulfilling life.

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Everything You Need To Know

What specific factors influence physical activity during a COPD exacerbation?

Several key factors influence physical activity (PA) during a COPD exacerbation. These include the individual's age and overall health, with older individuals and those with poorer health-related quality of life (HRQoL) experiencing greater changes in PA. The living situation, such as living alone, also plays a role. Hospital stay duration and the use of certain medications, like anticholinergics or systemic corticosteroids, affect PA changes in hospitalized patients. Furthermore, the severity of the COPD, as measured by baseline FEV1% and dyspnea at rest, are significant predictors for patients not admitted to the hospital.

How does hospitalization affect physical activity levels in individuals experiencing a COPD flare-up?

Hospitalization during severe COPD exacerbations often leads to decreased mobility. Factors like the length of the hospital stay and the medications administered, such as anticholinergics or systemic corticosteroids, contribute to changes in physical activity levels. Prolonged periods of inactivity during hospitalization can also lead to a decline in overall health and quality of life, especially for older adults. The reduced activity within the first 24 hours of evaluation also plays a role.

What impact does pre-existing activity level have on the changes in physical activity during a COPD exacerbation?

Pre-existing activity levels significantly impact physical activity changes during COPD exacerbations. The study revealed that lower baseline PA and reduced activity levels within the first 24 hours of evaluation were associated with changes in PA. This indicates that individuals who are already less active may experience a more substantial decline in physical activity during a flare-up compared to those with higher baseline activity levels. This highlights the importance of maintaining a baseline fitness level to mitigate the negative impact of exacerbations.

What is the role of FEV1% and dyspnea in predicting physical activity changes during a COPD flare-up?

For patients not admitted to the hospital, baseline FEV1% (a measure of lung function) and dyspnea (shortness of breath) at rest upon ED arrival are significant predictors of change in physical activity (PA). A lower FEV1% indicates more severe airflow limitation, and greater dyspnea suggests more significant respiratory distress. Both factors reflect the severity of the exacerbation and impact the individual's ability to engage in physical activity. Therefore, assessing FEV1% and dyspnea can help healthcare professionals understand how a COPD flare-up affects activity levels.

How can individuals with COPD take control and regain their physical activity following a flare-up?

Individuals with COPD can regain their physical activity by understanding the determinants of physical activity changes during exacerbations. While some factors, like age, are non-modifiable, other factors can be influenced. Individuals should focus on maintaining baseline fitness, managing symptoms effectively, and working closely with healthcare professionals. Targeted interventions and lifestyle adjustments can help minimize the impact of exacerbations and support a return to an active and fulfilling life. This proactive approach empowers individuals to take control of their recovery and long-term health.