Skip to content

COPD – Feeling more energetic / Less Fatigued

Evidence Summary (Updated 2022)
A large body of good quality randomised controlled trial study data shows an improvement in fatigue, and energy levels. Improved endurance was also found in several studies along with those found to have improved walking distances and increased exercise capacity.(1–3)
Recent review strengthens this evidence with 2 further meta-analyses. A 12 study meta-analysis (n= 463) assessed fatigue by the CRQ showing that the mixed endurance and strength intervention improved significantly more than the usual care group [SMD 0.708; 95% CI 0.510, 0.907; p < 0.001; I² = 34.3%; p = 0.116].(4)
A 15 RCT SR and MA observed a reduction in fatigue following endurance, resistance, or a combination of both exercises. There was no significant difference between continuous and interval training (n = 3 studies, SMD= −0.17, 95% CI = −0.47, 0.12, p = 0.25) or between endurance and resistance training (n = 3 studies, SMD = −0.35, 95% CI = −0.72, 0.01, p = 0.07) on fatigue in people with COPD.(5)

Quality of Evidence
Grade B – moderate quality.

Strength of recommendation
Grade 1 – strong recommendation.

Physical activity and exercise interventions may significantly improve symptoms of fatigue and improve energy levels in people with COPD.


  1. Arnardóttir RH, Boman G, Larsson K, Hedenström H, Emtner M. Interval training compared with continuous training in patients with COPD. Respir Med [Internet]. 2007 Jun [cited 2022 Oct 5];101(6):1196–204. Available from:
  2. Mador MJ, Krawza M, Alhajhusian A, Khan AI, Shaffer M, Kufel TJ. Interval training versus continuous training in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev [Internet]. 2009 Mar 1 [cited 2022 Oct 4];29(2):126–32. Available from:
  3. Zwerink M, Brusse-Keizer M, van der Valk PDLPM, Zielhuis GA, Monninkhof EM, van der Palen J, et al. Self management for patients with chronic obstructive pulmonary disease. Cochrane database Syst Rev [Internet]. 2014 Mar 24 [cited 2022 Oct 5];2014(3). Available from:
  4. Paneroni M, Vitacca M, Venturelli M, Simonelli C, Bertacchini L, Scalvini S, et al. The impact of exercise training on fatigue in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Pulmonology [Internet]. 2020 Sep 1 [cited 2022 Oct 5];26(5):304–13. Available from:
  5. Li LSK, Butler S, Goldstein R, Brooks D. Comparing the impact of different exercise interventions on fatigue in individuals with COPD: A systematic review and meta-analysis. Chron Respir Dis [Internet]. 2019 [cited 2022 Oct 5];16. Available from: