Unravelling the complex interplay of factors behind exercise limitations and physical inactivity in COPD

Exercise limitation and physical inactivity are known treatable traits for people with COPD. Maximising exercise capacity and keeping people physically active improves health status and survival rates among people with COPD. However, managing these two treatable traits can be extremely challenging for clinicians due to the complex intersectionality of factors influencing an individual ' s capacity, opportunity and motivation to engage in physical activity. This review presents the complex factors influencing exercise capacity ( " can do " ), levels of physical activity ( " do do " ) and sedentary behaviours amongst people with COPD and provides practical recommendations on how clinicians can address some of these factors in practice. Most importantly, it highlights the importance of referring to pulmonary rehabilitation as a way to improve exercise capacity among people with COPD.