Light physical activity (PA) significantly improved survival in adults with chronic obstructive pulmonary disease (COPD), based on new data from more than 800 individuals.

Previous research has shown that daily PA is the strongest predictor of survival among individuals living with COPD, wrote Roberto P. Benzo, MD, a pulmonologist at the Mayo Clinic in Phoenix, and colleagues in an abstract presented at the American Thoracic Society (ATS) 2026 International Conference.

Patients with COPD experience breathlessness, functional limitations, and reduced tolerance for exercise that challenge their ability to achieve the 150 minutes of weekly moderate intensity activity recommended for healthy individuals by the American Heart Association.

However, data on the amount and intensity of daily PA that may improve survival in patients with COPD are lacking, particularly for light and moderate levels of PA, defined as 1.5-3 and 3-6 metabolic equivalent of tasks (METs), respectively, the researchers noted. One MET is defined as the amount of energy used when sitting quietly.

To assess the impact of different intensities of daily PA on survival in patients with COPD, the researchers recruited 872 adults with COPD. The mean age of the participants was 69 years, 54% were women, the mean score on the modified Medical Research Council (mMRC) score on a scale of 0-4 was 2.6, and the mean forced expiratory volume per second (FEV₁) was 46%.

All participants wore a tri-axial wrist accelerometer to monitor activity for 7 days; 70% of the participants were randomly assigned to a training dataset and 30% to a validation set. Survival was assessed at the end of a 72-month follow-up period, with a mean follow-up of 42 months. The researchers used bootstrapped classification and regression tree models that included 3000 iterations.

At the end of the follow-up period, approximately two thirds (67.3%) of the participants were alive, and 32.7% were deceased.

Overall, survival was associated with cut points of 17 min/d of moderate PA, 296 min/d of light PA, and 3243 steps/d after adjusting for age, sex, FEV₁, and mMRC scores, with adjusted hazard ratios of 0.42 for all three categories in the training set.

In addition, two 10-minute bouts of moderate intensity PA per day showed similar survival benefits (58% improvement in survival) to the light activity, moderate activity, and daily steps cut points, the researchers noted.

The study is the first known to document the similar survival benefits of light PA compared to moderate activity in patients with COPD, the researchers wrote. In the context of many patients with COPD who are not able to meet standard guidelines for PA, “our results represent a breath of fresh air, suggesting that simple and meaningful (to the patient) light activities may provide a survival benefit,” they concluded.

Support for Achievable Activity Levels

Current exercise guidelines are often unrealistic for patients with COPD, and the new study helps to fill a knowledge gap as to the benefits of light-intensity PA, said Jesse R. Sherratt, DO, a pulmonologist and critical care specialist at the University of Texas Health Science Center at San Antonio.

“I was somewhat surprised that light PA alone was associated with improved survival as most prior recommendations have focused on moderate-intensity exercise,” said Sherratt, who was not involved in the study. “However, the findings are consistent with previous evidence showing that greater overall physical activity leads to better outcomes in COPD,” he noted.

The study identified activity thresholds associated with improved survival but did not establish how clinicians can effectively help patients reach these targets, Sherratt noted. “Future randomized studies should evaluate interventions that increase light physical activity and determine whether doing so leads to improved clinical outcomes,” he said.

However, the results suggest that clinicians can encourage patients with COPD to increase light daily activity, even if they cannot meet traditional exercise guidelines, which may improve counseling and make PA goals more realistic and attainable, Sherratt said.

The study was funded by the National Institutes of Health. The researchers had no financial conflicts to disclose. Sherratt had no financial conflicts to disclose.