Probiotics in Pulmonaty Rehabilitation for COPD

This study is testing whether adding a probiotic supplement to pulmonary rehabilitation (a structured exercise and education program for lung patients) can improve outcomes for people with COPD (chronic obstructive pulmonary disease) or pre-COPD. **You may be eligible if...** - You have been diagnosed with pre-COPD or COPD (stage I–IV) according to 2023 GOLD guidelines - You are currently undergoing pulmonary rehabilitation for more than three months - You are willing to sign an informed consent **You may NOT be eligible if...** - You are under 18 - You have a neuromuscular disease - You have had a COPD exacerbation (flare-up) requiring emergency care or hospitalization in the past 3 months - You cannot complete cardiopulmonary exercise testing - You have other conditions preventing you from exercising for over a year - You have severe malnutrition or very low BMI Talk to your doctor to see if this trial is right for you.