Our findings further support the importance of physical activity in the management of COPD across the care continuum. Although it is possible that lower physical activity is a reflection of worse disease, promoting and supporting physical activity is a promising strategy to reduce the risk of readmission.

Pulmonary arterial hypertension is a group of disorders defined by a progressive elevation of pulmonary vascular resistance in the small pulmonary arteries and arterioles. In its untreated form, the disease causes progressive dyspnea and severe activity limitation resulting in premature death due to right ventricular failure. However, the advent of multiple-targeted medical therapies has significantly altered the prognosis of this disorder, allowing patients to live longer with increased functional ability. Given the trend in prognosis and functionality, this review revisits the possible role for exercise training in patients with pulmonary arterial hypertension. The evidence suggesting that exercise may be safe in these patients is summarized and a potential exercise prescription is suggested.

Patients with COPD who were non-ambulatory within 24 h prior to discharge were at significantly greater risk of readmission compared to ambulatory patients. Functional status should be used to risk stratify patients for more intensive supportive interventions post discharge.

Key Points Question What is the real-world effectiveness of a 12-month community-based physical activity (PA) coaching intervention on reducing all-cause acute care use and death in patients with a history of a chronic obstructive pulmonary disease (COPD) exacerbation? Findings In this multisite, randomized clinical trial that included a population-based sample of 2707 patients with COPD, 321 of 1358 patients participated in the PA coaching intervention and increased PA significantly, but there were no significant differences in the all-cause primary outcome (compostite measure of all-cause hospitalizations, observation stays, emergency department visits, and death) at 12 months. Meaning Most patients with a COPD exacerbation did not engage in PA, and the limited PA did not lead to significant benefit in 12-month health care use.

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