Inclusion Criteria:  Confirmed diagnostic of COPD Severity of COPD: global initiative for chronic obstructive lung disease (GOLD) classification III or IV Undergoing a pulmonary rehabilitation program in J. Bracops Hospital  Exclusion Criteria:  Cardiac or orthopedic complications limiting participation in occupational therapy sessions Active smoking Inability to understand the French language orally or in writing Cognitive impairments limiting understanding of instructions and participation in occupational therapy sessions