The value of being physically fit is well described in the literature. The data seem to indicate that being physically active confers significant benefit. Rehabilitation interventions based upon improving physical activity (PA) and exercise capacity add value at all stages of the disease. The traditional aim of pulmonary rehabilitation has been to enhance exercise capacity, and this is reflected in the choice of commonly reported outcome measures. In the absence of directly measured PA, it is assumed that increased exercise capacity is a key mediator to increase PA. The explicit expectations of rehabilitation have altered and there is now the challenge of not only increasing exercise capacity but also PA.
The challenge of improving PA is complex and in reality is beyond the health care system alone. Many models have been proposed that describe PA and important factors that may either enhance or discourage PA. As health care professionals, we can realistically focus our efforts’ on the individual and their interaction with their carers and their environment, but it is the role of the government to address policy and wider environmental issues to facilitate and sustain local PA opportunities.