NONE 20260102090751594 wseas/wseas content-registration-form+ja@crossref.org content-registration-form WSEAS TRANSACTIONS ON BIOLOGY AND BIOMEDICINE 1109-9518 2224-2902 Geng Chen Open Education Center, Mongolian University of Science and Technology, Ulaanbaatar 14191, MONGOLIA Bat-Ochir Magsar Open Education Center, Mongolian University of Science and Technology, Ulaanbaatar 14191, MONGOLIA D. Enkhtuya Open Education Center Mongolian University of Science and Technology Ulaanbaatar 14191 MONGOLIA Guochang Liu Department of Public Sports and Arts Huanghe Science and Technology University Zhengzhou 450006 CHINA Yuedan Wu School of Medicine Zhengzhou University of Industrial Technology Zhengzhou 450064 CHINA Yongmiao Sun Department of Musculoskeletal Pain Rehabilitation The Fifth Affiliated Hospital of Zhengzhou University Zhengzhou 450000 CHINA 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. 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