Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable lung disease. People with COPD must work harder to breathe, which can lead to shortness of breath and/or feeling tired. Early in the disease, people with COPD may feel short of breath when they exercise. As the disease progresses, it can be hard to breathe out (exhale) or even breathe in (inhale). A person with COPD may have obstructive bronchiolitis emphysema, or a combination of both conditions. There is variety of treatment like breathing exercises, inspiratory muscle training exercises, resistance training and aerobic exercise to improve lung function as well as to decrease the chances of cardiopulmonary complications. the purpose of this study it to observe the effects of hand gripping isometric exercises on pulmonary functions in COPD patients.

Study design will be randomized clinical trial in which experiment group will receive isometric training with resistance training and other group will only receive resistance training . Total forty eight participates will recruited with convince sampling, after that we will use simple random sampling to divide the patient into both equal groups. Digital spirometry will be used to document the pulmonary function also to observe the difference in post treatment.Data analysis will be done using SPSS version 25.

The most common respiratory symptoms associated with COPD include dyspnea, cough and/or sputum production. In addition to the daily symptom burden, COPD may be punctuated by periods of acute worsening of respiratory symptoms (often referred to as 'exacerbations'), which account for the greatest proportion of total COPD burden on healthcare systems. COPD can be progressive, as indicated by reductions in spirometry measures such as forced expiratory volume in 1 s (FEV1) over time, though patients may progress at different rates.

Physical exercise is a major component of the total therapeutic regimen in pulmonary rehabilitation and has been positively correlated with better lung function in all age groups. Physical activity may attenuate age-related decline in pulmonary function and should be an integral part of pulmonary rehabilitation to improve lung function. Respiratory diseases constitute a major socioeconomic and a massive health burden all over the world. It represents an enormous drain on human and financial resources, and also contributes largely to morbidity and mortality at both global and national scales.

Age related decline in pulmonary function even in the absence of extrinsic pollutants, which can be caused by several factors related to the lung tissue itself. This age related decline further causes a reduction in exercise capacity and contributes immensely to loss of muscle power and mobility with progressive airflow limitation. The reduction in muscle power and increased airflow limitation contribute to the loss of muscle mass, decreased functional capacity and eventually loss of independence .Handgrip exercises are easy to perform, take less space and are more accessible in various locations such as hospitals, schools, in transit and in the home; therefore, it can lead to increased adherence to treatment.

A good number of scientific studies clearly demonstrate that isometric exercise is efficacious in the attenuation of resting blood pressure in both normotensive and hypertensive subjects. Isometric exercise produced greater reductions in systolic and diastolic blood pressure compared to dynamic exercise training. Moreover, physical exercise has been shown to be a non-pharmacological prophylactic regimen as it is capable of protecting against decline in pulmonary functions due to aging and enhances the physiological responses of the lungs.

Inclusion Criteria:

• Age range from 40 to 70 years
• Clinical or functional diagnosis of COPD criteria GOLD II and III
• Clinically stable (outside the period of exacerbation of the disease for at least 3 months),
• Independently able to perform instrumental activities of daily living, as assessed by the functional activities questionnaire
• No medical contraindications for physical exercise

Exclusion Criteria:

• Pulmonary diseases such as asthma, pulmonary fibrosis, pneumonia and other non-pulmonary
• Sever or difficult to control ( heart disease or sequelae of acute or chronic orthopedic and/or neurological diseases),
• Those who use walking assist devices that could influence the exercise
• Enrolled in a physical training program within the last 3 months at baseline