The role of prior exercise in chronic obstructive pulmonary disease and recovery

Chronic Obstructive Pulmonary Disease (COPD) is a debilitating airway illness with several co-morbidities, including hypertension, muscle dysfunction, clinical depression, cachexia, osteoporosis and anemia. A hallmark of the illness is breathlessness (dyspnea) due to airway obstruction, which reduces mobility and leads to a downward spiral of incapacitation. Dyspnea is a primary complaint addressed by pharmacological means, which temporarily widens airways, but cannot reverse the progression of additional lung obstruction. Ultimately, the stress of breathelessness and comorbidities results in death, often by cardiovascular failure or cancer. Although smoking is the primary risk factor for COPD, only a small percentage of smokers develop the disease. Current research highlights new factors that enhance one's risk for COPD, including exposure to noxious air particulates (a problem in developing nations), genetic and epigenetic factors, childhood infections, and obesity. In light of such factors, we propose exercise as an additional factor for consideration. Because exercise is touted as a ubiquitous means to promote health, will long-term, consistent exercise starting from the teenage years affect the development or progression of COPD in smokers? We investigate this question using a novel retrospective activity survey comparing self-reported lifetime exercise to lung function test values in 30 smokers. To our knowledge, this is the first retrospective lifetime exercise study of individuals with at least a 10 pack-year smoking histor