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Physical inactivity is a modifiable and widespread risk factor in chronic disease populations, including those with obstructive pulmonary disease and recipients of lung transplantation (LT). While LT restores respiratory function, full physical recovery remains elusive. Muscle weakness and reduced exercise tolerance are common and often worsened by immunosuppressive therapies, immobility and nutritional deficits.1 Notably, prolonged sedentary behaviour is independently associated with long-term morbidity and mortality,1 2 even among patients meeting activity recommendations.3