Chronic obstructive pulmonary disease is a major cause of mortality and morbidity worldwide with inflated costs for treatment and rehabilitation. Physiotherapy is clinically beneficial for rehabilitation of COPD patients but there is a lack of scientific analysis and comparison of physiotherapy effects in severe COPD patients. Therefore, we applied a detailed systematic approach to investigate the effect of all potential physiotherapy techniques on motor function in COPD exacerbation patients. We pooled data from 315 trials published in databases such as PubMed, etc. Colleagues independently reviewed these studies and any of the above study patients with exacerbated COPD were randomly allocated to receive diverse physiotherapy techniques. Primary outcomes were exercise distance and endurance time. Thirteen studies were eventually included in this study. Overall physiotherapy techniques contributed to significantly improved motor function (standardized mean difference 25.96, 95% confidence interval (CI) 19.08 to 32.85) including longer exercise distance (weighted mean difference), and longer endurance time (standardized mean difference). Specifically, results of TENS and HFCWO indicated a significant improvement of motor function of COPD patients (overall p = 0.003 and < 0.00001, respectively) while ELTGOL did not statistically ameliorate motor function after COPD exacerbation (overall p = 0.43). In general, physiotherapy techniques are effective in improving severe COPD patient motor function. Further research is needed to elucidate its effect on other outcomes and to determine the optimal use of physical therapy.

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