COPD: Working Out to Breathe In

Chronic obstructive pulmonary disease and physical activity

/ Author:  / Reviewed by: Robert Carlson, M.D

If you have trouble breathing because of chronic obstructive pulmonary disease (COPD), exercise might be the last thing on your mind. Be that as it may, exercise is crucial to your lung function and quality of life. So if you don't get up and get moving, you may be letting COPD take control of your life.

What is COPD?

COPD is a disease that makes it hard to breathe. It can cause mucus-filled coughs, wheezing, shortness of breath and chest tightness, among other symptoms.

Smoking is the most common cause of COPD. But the disease can also develop from long-term exposure to other substances, including air pollution, chemical fumes and dust.

According to the American College of Sports Medicine (ACSM), rates of COPD are on the rise in the United States, with an estimated 16.5 million Americans suffering the effects of the disease. However, the American Lung Association reports that nearly 24 million US adults have signs of impaired lung function, which suggests an underdiagnosis of COPD.

Sitting around with COPD

Because COPD causes shortness of breath and other breathing problems, some patients shy away from physical activity, which can lead to an increasingly inactive lifestyle. Inactivity not only allows the disease to get worse, but can also lead to a poor quality of life. As inactivity continues, patients become weaker and less fit.

According to the ACSM, "The deterioration in aerobic fitness and strength creates a vicious cycle that leads to greater breathlessness with exertion, muscular fatigue, and eventual loss of functional independence and depression."

How can exercise help?

Pulmonary rehabilitation programs, or exercise programs, for COPD patients are designed to reverse these consequences of inactivity.

COPD patients often fear that exercise will make their symptoms worse. But that is not the case. If you have COPD, exercise is beneficial to you in many ways, from improving symptoms to boosting self-esteem and overall quality of life.

"The misconception is that exercise could increase breathlessness and in turn shoot up anxiety," says Diane Shiao, PT, MSPT, DPT, of Revive Physical Therapy and Wellness in Edison, New Jersey. "Fear is a major reason why patients with COPD don't exercise. However, the results from studies have shown that regular exercise can increase functional capacity and endurance while reducing breathlessness, anxiety and fatigue."

The potential benefits of exercise for COPD patients include:

  • Improved heart function, which can improve circulation and the body's use of oxygen
  • Improved circulation can help with the exchange of oxygen and carbon dioxide in the body, which will ease shortness of breath
  • Higher energy levels, which allows you to do more activities without getting tired or losing breath
  • Lower blood pressure
  • Improved muscle strength, endurance, balance and flexibility, which allows greater activity
  • Improved posture, which makes it easier to breathe and use less energy
  • Improved sleep
  • Reduced fatigue
  • Less stress and anxiety about breathlessness
  • More independence in daily activities

Talk to your doctor!

Before you start any exercise program, it is crucial that you talk with your healthcare provider. Your doctor can help you figure out how much exercise you can handle and what types of exercise you should do.

You may want to discuss how often, how hard and how long you should exercise. You may also want to ask when to take your medications in relation to your exercise schedule.

"Always consult your doctor before starting an exercise program if you are unsure how to go about doing so without aggravating COPD symptoms," says Shiao. 

"Having an evaluation by a trained professional to determine the safest amount of exertion that should be placed on the body during exercise is necessary if the COPD is mild to moderate and if there is a cardiovascular issue involved as well," she says.

What is involved in exercise programs for COPD?

According to Shiao, "Pulmonary rehabilitation is important in preventing life-altering disability for those diagnosed with COPD. Exercise should include aerobic and strengthening components."

"It is advised to exercise at least 30 minutes daily, but the routine can also be divided into smaller spurts of exercise like interval training," she says.

Typically, exercise programs are divided into three components:

  • Warm up and stretching. It's important to prepare your body for exercise. Stretching before exercise can help you avoid injury and muscle strain. Over time, stretching can increase your range of motion and types of movements you are able to do.
  • Aerobic or cardiovascular exercise. This type of exercise boosts your blood flow and strengthens the heart and lungs. It also improves your body's ability to use oxygen. As you continue to do regular aerobic exercise, you may find it easier to breathe. That's because aerobic exercise can lower your heart rate and blood pressure, which means your heart won't have to work as hard while you exercise. Examples of aerobic exercise include walking, jogging, bike riding and swimming.
  • Muscle strengthening. This type of exercise involves using weights or elastic bands to repeatedly contract the muscles until they become tired. Patients with COPD find it especially helpful to do strengthening exercises for the upper body because they help boost the strength of the respiratory (breathing) muscles.

There are also specific breathing techniques involved in physical activity. While you are exercising, remember to breath slowly in order to conserve your breath. Inhale through your nose with your mouth closed, then exhale out of your mouth through pursed lips.

If you're unsure of how to start an exercise program for your COPD, find a physical therapist. A physical therapist can guide you through your exercises and help you track your progress.

Reviewed by: 
Review Date: 
April 2, 2013