Regular exercise can help you breathe easier and feel better

If chronic obstructive pulmonary disease (COPD) leaves you feeling tired and breathless, exercising may be the last thing you want to do. But it's near the top of the list of things you should do to alleviate your symptoms.

While exercise does not directly improve lung function, by conditioning your muscles it helps build your endurance level, which, in turn, improves how well your body uses oxygen. That means you won’t have to use as much energy to breathe, and you'll be able to do more before you start feeling tired.

Pulmonary Rehab

Many people with COPD benefit from exercise training that is part of a comprehensive pulmonary rehabilitation program. Typically, such programs are available through a hospital on an outpatient basis, and they meet three times a week for eight weeks.

The exercise portion of most programs focuses on endurance exercises to build leg strength, such as walking and stationary cycling. Some programs also include resistance exercises, using elastic bands or very light weights, to build leg strength. Improved leg strength helps make it easier to perform typical daily activities like preparing meals, housekeeping, and grooming, which can help you maintain your independence.

Some research also suggests that improving leg strength may reduce your risk of falling. As with leg strength, building upper arm strength with resistance training makes performing daily activities easier.

Are you a candidate? Most doctors recommend pulmonary rehabilitation for people with moderate to severe COPD (forced expiratory volume at one second [FEV1] below 50 percent of predicted value). And the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommends that doctors consider it for people with mild COPD (FEV1 at or below 80 percent of the predicted value).

One recent study found that people with COPD found it easier to exercise after pulmonary rehab regardless of whether their condition was mild, moderate, or severe. Recent findings reported in the journal Age and Ageing suggest that advancing age shouldn't be a deterrent to pulmonary rehab. In a small study of 74 people with COPD who ranged in age from 65 to 83, a comprehensive program that included training of the upper and lower limbs significantly improved the distance the participants could walk in six minutes.

To find a rehab program nearby, ask your doctor for a referral. Or contact the American Lung Association (800-LUNGUSA; www.lungusa.org) or the American Association for Cardiovascular and Pulmonary Rehabilitation (312-644-6610; www.aacvpr.org).

Exercising on Your Own

Most people with COPD who don't have a pulmonary rehab program nearby or lack insurance coverage for such a program can and should exercise on their own. In fact, a recent study of 252 people with moderate to severe COPD—half of whom underwent outpatient rehab and half of whom had home-based rehab—found that both groups reported having less trouble breathing when performing daily activities after participating in an eight-week program. The findings, which were reported in the Annals of Internal Medicine, also showed that both groups felt their overall health status had improved.

For this study, participants performed various strength-training exercises (a maximum of three sets of 10 repetitions each for 30 minutes) and aerobic exercise (stationary cycling for 25 to 30 minutes) three times a week for eight weeks. But regular walking also can be a component of a home-based exercise program.

If you're not used to exercising, begin walking slowly at a very comfortable pace for a short period (try starting with five to 10 minutes daily) three to five days a week. Do not increase your walking time until you can walk the entire time without stopping to rest.

When you can walk without stopping, increase your walking time by one to two minutes each week. Make your goal walking 30 minutes without stopping—many people with severe lung disease are able to reach this goal over time. Try not to let bad weather stop you—you can always walk around your local mall if you can't exercise outdoors.

Beyond Walking

There are many daily physical activities that provide your body with exercise, including gardening, golfing, or even shopping. If you like ballroom dancing, swimming, yoga, or Pilates, ask your doctor if they're good options for you. It helps to choose activities you enjoy; that way you'll be more likely to stick with them.

The key to performing these activities safely is to pace your breathing in coordination with the activity. You can learn more about paced breathing through pulmonary rehabilitation or a COPD support group. Ask your doctor for a referral or check with the American Lung Association or the American Association for Cardiovascular and Pulmonary Rehabilitation.

Publication Review By: Peter B. Terry, M.D., M.A.

Published: 12 Aug 2013

Last Modified: 12 Aug 2013