Patients with chronic respiratory disease such as chronic obstructive pulmonary disease (COPD) are generally very inactive physically, and this physical inactivity is detrimental to their health. Physical inactivity not only impairs quality of life, it probably shortens life expectancy. Therefore, increasing physical activity should be a prominent goal in pulmonary rehabilitation. Physical activity levels correlate better with functional exercise capacity, such as the 6-minute walk distance, than abnormalities on pulmonary function tests. Because functional exercise capacity increases with pulmonary rehabilitation, and other important factors such as motivation and self-efficacy for exercise are also improved, it stands to reason pulmonary rehabilitation should increase activity and participation in extended activities of daily living. Indeed, an emerging medical literature suggests that this is so. We still need to know how effective we are in this area because meaningful changes in some of our outcomes, such as activity counts from motion detectors, have not been established. Pulmonary rehabilitation should incorporate specific interventions to make increased activity and participation specific goals of this comprehensive intervention.