Chronic obstructive pulmonary disease (COPD) is a common and very debilitating disease in the United States. COPD is characterized by plugging of airways with secretions, impaired airway integrity with airway collapse with effort, bronchospasm, frequent infections, destruction of alveolar tissue, and ventilation-to-perfusion inequality. This results in abnormalities in pulmonary mechanics and respiratory gas exchange, all of which make hyperventilation much less effective. However, research has shown that the pulmonary patient can improve work capacity in an exercise training program. Training also alleviates the severe emotional problems of anxiety, depression, and social isolation frequently present in COPD sufferers. Even the lowest level patient can frequently improve in a training program, and guidelines for the implementation of such a therapeutic regimen are provided.