Exercise Intolerance in COPD: A Review of the Pathophysiology and Clinical Assessment

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) frequently presents with significantimpairments that contribute to reduced functional capacity and exercise intolerance, ultimately leadingto compromised activity performance. Therefore, this study aimed to describe the pathophysiology andclinical assessment of exercise intolerance in COPD.Methods: Data used were procured through a thorough search of published literature, conducted usingboth PubMed and Google Scholar search engines. Literature was included when published in the last10 years, written in English, and available in full-text format. The types of literature used were books,original articles, narrative or systematic reviews, and case reports.Results: A total of 33 pieces of literature were identified and used to provide explanations for the subtopicsunder discussion. Out of the total pieces, 22 elucidated the pathophysiology of the topic, while theremaining 12 focused on the clinical assessment.Conclusion: Shortness of breath and leg fatigue were common symptoms of exercise intolerancefound in COPD. These symptoms were associated with impairment of the body functions such as therespiratory, cardiovascular, peripheral muscles, neuromuscular, and psychological. Furthermore, physicalinactivity caused worsening exercise intolerance, which could be evaluated using the Borg scale. Thecardiopulmonary exercise test was recommended to assess exercise intolerance in COPD patients andsome field analyses such as walk and step tests could also be carried out.