Management of dyspnea (shortness of breath) is a major concern for patients with COPD. The efficacy of complementary exercises to manage dyspnea is unknown. Complementary exercises may be more congruent with patients' lifestyles and values than traditional exercise programs and can be adapted to changes in illness severity and disability. Yoga practice is a complementary therapy that people use to manage their dyspnea. The aims of this study are to: 1) develop a safe and feasible yoga program for patients with COPD; 2) test the efficacy of this program; and 3) determine whether physical performance, psychological well being, and health-related quality of life are positively affected by yoga practice.

Patients in this study will be randomized to receive yoga training or usual care for 12 weeks. Patients will be evaluated at study entry, after each session, and immediately after the training program.

Inclusion criteria:

• Able to commit to a 12-week yoga class in San Francisco, California
• Moderate to severe COPD, clinically stable for at least 1 month prior to study entry
• Forced Expiratory Volume at one minute (FEV1) < 49% predicted after inhaled bronchodilator
• Activities of daily living limited by shortness of breath
• Ability to speak English and sign consent
• Patients receiving supplemental oxygen will be acceptable if their O2 saturation can be maintained at > 85% on < 6 L/min of nasal oxygen

Exclusion criteria:

• Symptomatic illness (e.g., cancer, left heart failure, ischemic heart disease, neuromuscular disease, psychiatric illness)
• Formal pulmonary rehabilitation training within 1 year prior to study entry