Luca is a 68 year old male with moderate COPD who is referred for physical therapy to improve exercise tolerance. He reports dyspnea with minimal exertion and has a 6-minute walk test distance of 250 meters. His resting oxygen saturation is 92% on room air. Which of the following is the MOST appropriate initial exercise approach?

A) Interval training with short work and rest periods at moderate intensity

B) Continuous training at 75% of peak work rate to build endurance

C) Resisted walking with a weighted vest to strengthen lower extremities

D) Breathing retraining combined with unsupported upper extremity exercises

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