Chronic obstructive pulmonary disease (COPD) is the fifth leading cause of mortality in the USA. For 1984 to 1993, among Canadian seniors aged over 65, COPD was the fourth cause of mortality in men and the seventh in women. Though the underlying pathology is initially confined to the lungs, the associated physical deconditioning and the emotional responses to chronic respiratory disease contribute greatly to the resulting morbidity. Increased shortness of breath leads to inactivity and consequent cardiorespiratory and muscular deconditioning, which in turn leads to further inactivity, social isolation, fear of dyspnoea and depression. Respiratory rehabilitation may offer a way to break this vicious circle.