How to Exercise If You Have COPD


If you've got chronic obstructive pulmonary disease (COPD), it's more important than ever to get some exercise—it can save your lung function and slow down the progression of COPD. The problem? The shortness of breath that comes with exertion can make it tempting to move less than you did before. This sets up a vicious cycle: shortness of breath leads to inactivity, which leads to a decline in fitness, which leads to further shortness of breath and inactivity.

To get out of the rut, Michael Berry, PhD, chair of the department of health and exercise science at Wake Forest University, in Winston-Salem, N.C., recommends walking, stationary biking, and elliptical training. They work well for people with COPD, but strength and resistance training are playing an increasing role in patients regimens.

As we age, people—particularly those over the age of 60—lose muscle fibers, according to Berry. Healthy people lose fast-twitch muscles, which are used for short bursts of energy. But individuals with COPD tend to lose slow-twitch muscles, which are used for endurance activities as well.

Weight training helps to improve skeletal muscle function so patients can remain active longer. Exercise of the lower legs—frequently walking or cycling—is the main focus of any organized exercise program for COPD, says Gail Weinmann, MD, the deputy director of the National Heart, Lung and Blood Institutes Division of Lung Diseases, but exercising the upper arms through resistance training is also helpful. (Like anyone starting an exercise program, a person with COPD should be cleared for exercise by a health care provider, Dr. Weinmann cautions.)

If you have COPD, another advantage of exercising the respiratory system is to learn how to cope with the panic that can occur with shortness of breath.

“I have heard it described as when someone is hit in the stomach and cant get their breath,” Berry says. “Exercise teaches people how to deal with that sensation, to work through it. They know they are going to get up the steps, and they will get short of breath, but now they know, ‘Im not going to keel over and die.”

Breathing techniques can fight panicky feelings
Mike McBride, a COPD patient from Arvada, Colo., who racewalks with oxygen in tow, says the first time he walked around his neighborhood for exercise, he thought he was going to have to call someone to pick him up. Over the years he has had setbacks and has learned his limits, but he continues to exercise at the gym and walks at least three times a week.

“Learning to deal with the panic is the first thing to get past,” McBride says.

Respiratory therapists offer two common breathing techniques: pursed lip and diaphragm breathing. Pursed lip breathing is performed by inhaling through the nose and then exhaling through pursed lips (as if one is going to whistle). The exhale should be longer than the inhale, but air should not be forced out. This breathing helps people relax and reduces the amount of air trapped in the lungs. Diaphragm breathing helps to strengthen this important muscle and is accomplished by lying on ones back with knees bent and making the stomach, rather than the chest, move out while inhaling and in while exhaling.

Patients are typically introduced to breathing exercises only when they visit a respiratory therapist or participate in a pulmonary rehabilitation program, Berry says, mainly because time-crunched primary care physicians focus on exercise and smoking cessation.

McBrides insurance would not pay for respiratory therapy, so he utilized breathing techniques he learned during Lamaze classes years ago. He visualizes wringing out a towel when he starts to panic and concentrates on breathing out twice as long as he breathes in.

“A lot of people dont want to do anything because they are afraid of getting short of breath," he says. "It doesnt scare me anymore because I have had enough experience with the distress part.”