[Physiotherapy during and after acute exacerbation of COPD]

Exacerbations are major events in the course and prognosis of COPD. Following acute exacerbation of COPD (AECOPD), functional recovery is not always complete and the risk of relapse is high, requiring proactive management.Pulmonary and extrapulmonary consequences of AECOPD require comprehensive and individualized care. Muscle function and nutritional status are key elements to target. Pulmonary rehabilitation is an effective strategy designed to deal with these aspects and to facilitate a comprehensive, patient-centered approach.Access to pulmonary rehabilitation programs is limited, and existing barriers need to be more precisely identified as a first step toward their possible removal. Long-term exercise maintenance strategies likewise warrant further study.The physiotherapist has a major role to assume in per- and post-exacerbation management of people with COPD; it is up to him to assess the patient and to put into place an individualized pulmonary rehabilitation program; it is also up to him to provide long-term support, helping the patient to maintain an active lifestyle while coping with a chronic pathology.