Functional performance and physical activity in chronic obstructive pulmonary disease: theoretical perspectives

Two paradigms are commonly used to evaluate the functional limitations and restrictions imposed by the progression of COPD. The disabilities paradigm serves as a tool to evaluate a patient's functional status and details methods of managing disabilities and the health and fitness paradigm quantifies fitness and promotes physical activity as a means of regaining health. Functional capacity and physical symptoms are the most important predictors of functional performance. The functional status and disabilities models have been effective in identifying predictors of functional capacity and functional performance and to describe the effects on pulmonary rehabilitation. The emphasis has been placed on functional capacity rather than preventing future comorbidities. It is possible, however, to make further gains in health by also emphasizing physical activity. The health and fitness paradigm for individuals with COPD distinguishes between the health benefits of physical activity and the health benefits of physical fitness. Linking the two paradigms may ultimately improve the health and functioning of people with COPD.