Abstract: To evaluate the effectiveness of a multimodal rehabilitation treatment (MT) that integrates structured exercise and imaging-based assessment on clinical outcomes in elderly patients with stable chronic obstructive pulmonary disease (COPD). A total of 104 elderly patients with stable COPD were randomized to a Test group (n=52, MT intervention) and a control group (n=52, standard care). Outcomes were assessed at baseline, week 6, and week 12, including the 6-minute walk test (6MWT), dyspnea (modified Medical Research Council scale, mMRC), anxiety and depression (HADS-A/D), self-efficacy for exercise scale (SEE), exercise benefits/barriers scale (EBBS), COPD assessment test (CAT), and lung structural changes assessed by CT imaging. Assessments were conducted at baseline, six weeks, and twelve weeks. After completing the test for 12 weeks, the exercise endurance of the Test group increased significantly, and the level of dyspnea decreased dramatically compared to the control group. The negative emotions of the Test group were significantly lower than those of the control group (p<0.05). In addition, they reported significantly higher levels of exercise self-efficacy, perceived exercise behavior, and quality of life than the control group (p<0.05). The clinical indicators and imaging examination results of the experimental group were significantly improved compared with those of the control group. Patients in the Test group had an exercise adherence rate of 91.84% over the 6-week study period and 97.96% over the 12-week study period. Mixed-effects modeling supported significant group-by-time interactions across key endpoints. The use of MT in geriatric pulmonary rehabilitation has been shown to reduce dyspnea and emotional distress, increase exercise endurance, improve positive perceptions of exercise behavior, and improve quality of life in elderly patients with COPD.

Keywords: Exercise Intervention, COPD, Elderly Patients, MT, Exercise Tolerance

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