Exercise Intolerance in COPD: A Review of the Pathophysiology and Clinical Assessment
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Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) frequently presents with significant
impairments that contribute to reduced functional capacity and exercise intolerance, ultimately leading
to compromised activity performance. Therefore, this study aimed to describe the pathophysiology and
clinical assessment of exercise intolerance in COPD.
Methods: Data used were procured through a thorough search of published literature, conducted using
both PubMed and Google Scholar search engines. Literature was included when published in the last
10 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 subtopics
under discussion. Out of the total pieces, 22 elucidated the pathophysiology of the topic, while the
remaining 12 focused on the clinical assessment.
Conclusion: Shortness of breath and leg fatigue were common symptoms of exercise intolerance
found in COPD. These symptoms were associated with impairment of the body functions such as the
respiratory, cardiovascular, peripheral muscles, neuromuscular, and psychological. Furthermore, physical
inactivity caused worsening exercise intolerance, which could be evaluated using the Borg scale. The
cardiopulmonary exercise test was recommended to assess exercise intolerance in COPD patients and
some field analyses such as walk and step tests could also be carried out.
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