Chronic obstructive pulmonary disease (COPD) is widely spread all over the world. It is predicted to be the third leading cause of death by 2020[1]. COPD is a common, preventable treatable disease that is characterized by an airflow limitation which is not fully reversable[2].

Chronic obstructive pulmonary disease (COPD) is widely spread all over the world. It is predicted to be the third leading cause of death by 2020. COPD is a common, preventable treatable disease that is characterized by an airflow limitation which is not fully reversable.Not only the long-term exposition to noxious particles and gases contributes to the development of COPD, but also so many others factors such as genetics and cigarette smoking. It has been shown that cigarettes are harmful and contributed to different extra pulmonary disorders. Indeed, it induced a systemic inflammation that was considered as a key process in the pathogenesis of COPD and triggered the activation of inflammatory cells and an abnormal increase of circulating cytokines such as CRP, interleukin (IL6), IL8, tumor necrosis factor alpha (TNF alpha) and leptin.

Inclusion Criteria:

• COPD diagnosed by pulmonary function testing
• Clinically stable
• Abscence of other obstructive diseases
• Signed written consent

Exclusion Criteria:

• Neuromuscular diseases -Severe psychiatric, neurologic or musculoskeletal conditions and /or instable--- --
• cardiovascular diseases.
• Contre-indications to physical therapy
• Acute exacerbations a month before the intervention