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Updated: Sep 24, 2025

Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease

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Published on: August 24, 2019

Physical Activity, Exercise Capacity, and Body Composition in U.S. Veterans with Chronic Obstructive Pulmonary

Emily S Wan^1,2,3, Madeline Polak¹, Rebekah L Goldstein¹

¹Pulmonary, Allergy, Sleep and Critical Care Medicine Section.

Annals of the American Thoracic Society

|May 10, 2022

Summary

Body composition, including both lean and fat mass, impacts exercise capacity and physical activity in chronic obstructive pulmonary disease (COPD) patients. A higher ratio of appendicular skeletal muscle mass to weight is linked to better exercise capacity and physical activity levels in COPD.

Keywords:

COPD body composition exercise tolerance physical activity

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Published on: February 20, 2017

Area of Science:

Pulmonary Medicine
Body Composition Analysis
Exercise Physiology

Background:

Body composition variability influences exercise capacity (EC) and physical activity (PA) in chronic obstructive pulmonary disease (COPD).
Previous research primarily used bioimpedance, with limited studies employing dual X-ray absorptiometry (DXA) for comprehensive body composition assessment, including fat mass.
Understanding the differential impact of lean and fat mass on EC and PA is crucial for managing COPD patients.

Purpose of the Study:

To investigate the distinct associations of DXA-assessed muscle (lean) mass and fat mass with EC and PA in individuals with COPD.
To determine if body composition metrics incorporating both lean and fat mass offer better predictive value for EC and PA.

Main Methods:

DXA was used to assess body composition in U.S. veterans with COPD.
Exercise capacity was measured by the 6-minute-walk distance (6MWD), and physical activity was assessed using objective step counts and self-report.
Spearman correlations and multivariable models, adjusted for age, sex, race, and lung function, were used to analyze associations.

Main Results:

Modest inverse correlations were found between EC and PA with fat mass.
Muscle (lean) mass alone showed no significant association with EC or PA.
The ratio of appendicular skeletal muscle mass (ASM) to weight demonstrated consistent associations with EC, objective PA, and self-reported PA in adjusted models.

Conclusions:

DXA-derived body composition metrics that account for both lean and fat mass are significantly associated with cross-sectional EC and PA in COPD patients.
The ASM-to-weight ratio emerges as a key indicator of functional status in COPD.
These findings highlight the importance of comprehensive body composition assessment in COPD management and research.