Effects of Eccentric Exercise Training in Patients With COPD

Inclusion Criteria: * Having undergone pulmonary rehabilitation for more than 3 months * Sign the written informed consent form * FEV1/FVC \< 0.70 * Approval for exercise training granted by a specialist physician's assessment * Specialist physician's approval for exercise training Exclusion Criteria: * Existing of tracheostomy * Those who use oxygen therapy or ventilator at home * Severe heart failure (NYHA III-IV) * Neuromuscular disease * Acute exacerbation within the past three months * Those who are unable to cooperate with the cardiopulmonary exercise test * Taking anticoagulant medications * Other conditions restricting exercise for over a year * Recent or planned significant cardiovascular surgery or intervention * Current or planned pregnancy within the next year * Planned heart transplant within the next six months * Heart failure due to uncorrectable valvular heart disease, congenital heart disease or obstructive cardiomyopathy * Inadequate ICD settings for exercise heart rate * Other exercise contraindications: unstable angina, uncontrolled blood pressure, orthostatic hypotension with symptoms, severe aortic stenosis, acute discomfort or fever, uncontrolled arrhythmias, uncompensated heart failure, acute pericarditis or myocarditis, recent thrombosis or thrombophlebitis, resting ST-segment deviation, uncontrolled diabetes, etc.