Physical activity and fatigue in patients with COPD

Fatigue is the second most important symptom in patients with chronic obstructive pulmonary disease (COPD) after breathlessness, yet it remains underrecognized in clinical care and research. Unlike airflow limitation, fatigue arises from complex, multifactorial mechanisms and its relationship with physical activity is poorly understood.

To explore this in more detail, a multicentre study was conducted across six European countries, including 609 patients with COPD who were followed for two years with assessments every six months. Physical activity was objectively measured using wearable devices, while fatigue was evaluated through the FACIT-Fatigue questionnaire.

Data of this study presented by Paulien Mellaerts at ERS 2025 showed that patients who experienced greater declines in physical activity reported significantly more fatigue and had a worse health status at follow-up. For every 1,000-step reduction in daily activity over a one-year period, a measurable decrease in the FACIT score was observed, reflecting a worsening fatigue. Furthermore, reduced physical activity was also linked to a poorer exercise capacity and a worse lung function. Both step counts and movement intensity were predictive of fatigue progression.

These findings highlight that maintaining physical activity is essential in managing fatigue and preserving health status in COPD. Building on this, a new study in Leuven is now assessing muscle-specific fatigue in COPD patients using objective leg measurements.