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Chronic obstructive pulmonary disease (COPD) usually presents as either chronic bronchitis or emphysema and it affects quality of life, leading to disability and early death. 1 It is one of the main causes of death in the world. 2 Emphysema is defined as the progressive and irreversible destruction of alveolar sacs leading to a loss of lung recoil, early airway collapse, and loss of alveolar gas exchange surface area. 3 Airway collapse leads to air trapping and its presence has correlated with an increase in mortality. 4 In addition to static air trapping, patients develop dynamic hyperinflation, which leads to exercise intolerance and physical deconditioning. 5

Standard treatment of COPD involves smoking cessation, therapies, such as long-acting bronchodilators and anticholinergic agents, oxygen therapy, and pulmonary rehabilitation programs. 6 Unfortunately, many patients continue to decline despite such …