The Effect of a Technology-Mediated Integrated Walking and Tai Chi Intervention on Physical Function in Veterans With COPD and Chronic Musculoskeletal Pain

Inclusion Criteria: * Male and female participants, aged 40 and older * Clinical diagnosis of COPD defined as history of cigarette consumption of \> 10 pack-years, and either a ratio of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) \< 0.70 or chest computerized tomography (CT) evidence of emphysema\* * Numeric Rating Scale pain score \> 3 for \> 3 months * Self-reported ability to walk a minimum of one block, bend at the hip, and transfer weight from one leg to another * Ability to complete 800 feet walk with Fitbit Inspire-2 recording \> 90% accuracy to detect steps compared to manual counts\* * Have access to a computer or smartphone with Internet connection or willing to come to study site to use study computers * Have access to videoconferencing audio and video capabilities * Competent to provide informed consent and willingness to make return study visits * Different criteria are used if baseline study visit is a virtual one. Exclusion Criteria: * COPD exacerbation in the previous 1 month * Clinical signs of unstable cardiovascular disease (active coronary artery disease, congestive heart failure, uncontrolled atrial fibrillation, or uncontrolled hypertension) * Oxygen saturation \< 85% recorded on baseline 4-meter walk\* * High fall risk (unable to perform 5 chair stand tests) * Inability to ambulate * Inability to complete questionnaires * Inability to collect at least 7 of 10 days of baseline step counts * Active substance abuse * Participation in a regular exercise (i.e., MOVE! or Gerofit) or Tai Chi program in the previous 3 months * Concurrent participation in another interventional research study * Receipt of hospice or end-of-life palliative care * Active medical intervention that would cause a meaningful increase in pain such as surgery, chemotherapy, or radiation therapy * Different criteria are used if baseline study visit is a virtual one.