Priority 16 from the COPD Exacerbation PSP

UNCERTAINTY: Does regular exercise reduce the risk of having an exacerbation (and to what level of exercise)? (JLA PSP Priority 16)
Overall ranking 16
JLA question ID 0104/16
Explanatory note This question seeks to understand whether regular exercise might be associated with better prevention of exacerbations.  There is good evidence that an education and exercise programme called 'Pulmonary Rehabiliation' is effective, but less evidence on what level of exercise in daily life would be required to maintain this benefit. 
Evidence

Limited evidence at COPD exacerbations.  
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011434.pub2/full

Health Research Classification System category Respiratory
Extra information provided by this PSP
Original uncertainty examples

how much exercise is wise as to not cause an exacerbation # ~ What is the minimal important difference of physical activity improvement from Physical activity interventions aiming to reduce exacerbations? ~ Does very regular exercise, to the point of pushing your breathing ability to the max, help maintain the lung capacity you have, or even improve it; and assist with keeping exacerbations at bay? ~ Does exercise impact on exacerbations or reduce them
What exercises can i do to prevent or should I rest? ~ Does daily physical activity regimen prevent AECOPD?

Submitted by Patient, Carer, Relative, Healthcare professional 
PSP information
PSP unique ID 0104
PSP name COPD Exacerbation PSP
Total number of uncertainties identified by this PSP. 51 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 1 April 2021