Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder associated with persistent airflow limitation, systemic inflammation, and marked impairment in exercise tolerance and quality of life. Exercise intolerance is a central feature of COPD and is strongly linked to increased dyspnea, reduced functional capacity, frequent hospitalizations, and poor clinical outcomes.

Objective: This narrative review aims to evaluate the effect of pulmonary rehabilitation on exercise tolerance in patients with COPD and to summarize evidence from commonly used functional outcome measures.

Methods: A narrative literature review was conducted using PubMed/MEDLINE, Embase, the Cochrane Library, and Google Scholar, including English-language studies published up to 2025. Studies involving adult COPD patients that assessed the impact of structured pulmonary rehabilitation programs incorporating exercise training were included. Exercise tolerance outcomes such as the six-minute walk test (6MWT), endurance exercise tests, dyspnea scores, and quality-of-life measures were reviewed qualitatively.

Results: Pulmonary rehabilitation consistently improved exercise tolerance in COPD patients. Increases in 6MWT distance ranged from 30 to 70 meters, exceeding the minimal clinically important difference. Endurance exercise capacity improved by 15–35%, accompanied by reductions in exertional dyspnea and clinically meaningful improvements in health-related quality of life. Short-term benefits were evident after 6–12 weeks of rehabilitation, while long-term maintenance depended on continued exercise participation. Programs combining aerobic and resistance training with supervised and individualized components produced the greatest benefits.

Conclusion: Pulmonary rehabilitation significantly enhances exercise tolerance, reduces symptoms, and improves quality of life in patients with COPD. Sustained engagement and personalized rehabilitation strategies are essential to maintain long-term benefits, reinforcing PR as a cornerstone of comprehensive COPD management.

Keywords: Pulmonary Rehabilitation, Exercise Tolerance, Functional Capacity