Effect of Breather in COPD Patients With Intermittent Claudication

Inclusion Criteria: * sixty male patients with diagnosed with grade I and grade II COPD their ages ranged between 55-60years * All patients will be clinically and medically stable when attending the study. * Body mass index (BMI) is 18.5 to 24.9 kg/m2. * History of unilateral exertional leg pain, * Ambulation during a graded treadmill test limited by leg pain consistent with intermittent claudication (stage II of the fontaine classification of pad), * And an ankle-brachial index (ABI) of 0.90 or lower at rest or 0.73 or lower after exercise. Exclusion Criteria: * cardiovascular insufficiency, * Recent myocardial infarction, * heart failure, * arrhythmia, * DVT, * Intracranial hypertension, * Pneumonia, * kidney failure, * fractures, * uncooperative patients, * cognitive impairment preventing a patient from participation in exercises.