Chronic obstructive pulmonary disease (COPD) is a globally prevalent and escalating health concern, significantly contributing to mortality and morbidity rates. Pulmonary telerehabilitation (PTele) has emerged as a promising alternative to traditional pulmonary rehabilitation (PR) for COPD management, improving patients’ exercise capacity and health-related quality of life. Nonetheless, the adoption of this technology in the PR context remains limited. In this pilot study, a novel approach is presented, enhancing a gamified telerehabilitation solution with cardiorespiratory biofeedback, specifically cardiorespiratory monitoring, and guidance on breathing exercise coordination (BEC). Ten patients with COPD with varying complexities, under the supervision of physiotherapists in a hospital setting, used the system for PR exercise training activities. The system received positive feedback, achieving high System Usability Scale (SUS) scores, with 76 points from the 10 patients and 70 points from the 4 physiotherapists. However, opinions on the integrated biofeedback system were mixed, indicating the need for improved clarity and seamless integration. These findings offer recommendations and valuable insights for enhancing biofeedback telerehabilitation in PR, facilitating the adaptation of existing PTele solutions, and promoting broader PTele adoption and PR automation.