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Physical inactivity is associated with adverse clinical outcomes, including hospitalization and all-cause mortality.

Increasing activity levels is crucial for effective management strategies and could lead to improved long-term outcomes.

In many patients, it also has detrimental extra-pulmonary effects, such as weight loss and skeletal muscle dysfunction/wasting [].

The pulmonary and skeletal muscle abnormalities limit the pulmonary ventilation and enhance the ventilatory requirements during exercise resulting in exercise-associated symptoms such as dyspnea and fatigue.

These tools are helpful for evaluating the patients’ perspectives on their ability to carry out daily activities.

Self-reported questionnaires and diaries rely on memory and recall of the patients [].

We suggest that a multimodal approach comprising pulmonary rehabilitation, pharmacotherapy, and counselling programs aimed at addressing emotional and behavioural aspects of COPD may be an effective way to increase physical activity and improve health status in the long term.

Muscle deconditioning, associated with reduced physical activity, contributes to further inactivity and as a result patients get trapped in a vicious cycle of declining physical activity levels and increasing symptoms with exercise (Figure ].Chronic obstructive pulmonary disease (COPD) is a debilitating disease affecting patients in daily life, both physically and emotionally.Symptoms such as dyspnea and muscle fatigue, lead to exercise intolerance, which, together with behavioral issues, trigger physical inactivity, a key feature of COPD.A unique project aimed at developing and validating patient reported outcome tools to investigate dimensions of physical activity that are judged as being essential by patients, is currently underway (PROactive; physical activity as a crucial patient reported outcome in COPD) and is due to be completed in 2014 [].Motion sensors, which include pedometers used for measuring steps and accelerometers used for detecting body acceleration, can be used for the objective quantification of physical activity over time [].

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