Effectiveness of DITM Versus IMT in COPD Patients

Inclusion Criteria: * Diagnosed as COPD according to "GOLD2024" * Lung function results FEV1/FVC\<60% * Patients with stable COPD who meet one of the following criteria: (A)with CAT score ≥10 or mMRC≥2; (B) ≥2 moderate acute exacerbation or ≥1 hospitalization in the past 12 months * Uses Budesonide MDI (Breztri Aerosphere) or Fluticasone, umeclidinium, and vilanterol (Trelegy Ellipta) or umeclidinium and vilanterol (Anoro Ellipta) as maintenance drug for COPD management * Volunteer to participate in this study and sign the informed consent form. If the subject is unable to read and sign the informed consent form due to incapacity, his/her guardian shall act on his/her behalf to read and sign the informed consent form. Exclusion Criteria: * Unstable angina or severe arrhythmia * Severe weakness-related fatigue, such as in advanced congestive heart failure or chemotherapy-related fatigue * Unstable mental illness with a risk of self-harm or harm to others * Severe cognitive impairment, progressive neuromuscular disease * Pregnant and breastfeeding women * Life expectancy of less than 6 months * Pregnant and breastfeeding women * Inability to cooperate with pulmonary function tests * Inability to complete the entire follow-up period * Vulnerable populations other than the elderly, including individuals with mental illness, cognitive impairment, critically ill patients, illiterate individuals, etc.