If you’ve been diagnosed with chronic obstructive pulmonary disease, you probably know that exercise is a key component of managing this progressive, incurable lung disease that makes it difficult to breathe. The COPD Foundation reports that “exercise itself cannot reverse COPD, but it can change the way you feel, breathe and function.”
And although exercise can’t reverse the lung damage that leads to COPD — often the result of years of cigarette smoking or inhaling airborne particles or fumes associated with certain occupations — it can help you avoid the deconditioning that can lead to more breathlessness and a worsening prognosis, thereby improving your quality of life.
A 2014 study in the Annals of the American Thoracic Society that looked at the association between physical activity levels and hospitalizations among a large group of COPD patients found that “participation in any level of regular moderate to vigorous physical activity … was associated with a significantly lower risk” of readmission to the hospital for any reason within 30 days of a prior hospital stay. The authors note that it’s “possible that physical inactivity is a reflection of worse disease,” but that the results still support the idea that “promoting and supporting physical activity is a promising strategy not only to reduce the risk of having the [initial] hospitalization but also to buffer the stresses of hospitalization. Our findings further support the importance of physical activity in the overall management of COPD across the care continuum, including care transition efforts to reduce 30-day readmissions.”
[See: 17 Ways Heart Health Varies in Women and Men.]
Additional studies have corroborated the importance of physical activity in managing COPD and improving quality of life, but which exercises are best and how should you begin incorporating them into your daily routine?
Get Checked Out
First, speak with your doctor before you begin any exercise routine. Find out whether you’re healthy enough to begin increasing your levels of physical activity. The pulmonary rehabilitation program that your doctor will likely prescribe as part of your COPD management protocol is a good place to start in learning which exercises are best and how to execute them correctly.
“In our pulmonary rehabilitation program, we do four different things as part of the exercise program,” says Scott Marlow, respiratory therapist at the Cleveland Clinic. “We do stretching and relaxation, strengthening and upper and lower body endurance.”
Stretching and Relaxation
Stretching is a great way to begin any exercise session and also a smart way to maintain flexibility as you age. Although the science about whether stretching prior to intense physical exercise prevents injury is mixed, it’s widely believed that muscles that are loose and limber are less likely to incur injury during any activity. For COPD patients, loosening up the muscles around the neck, chest and upper back may offer more room for the lungs to expand, which could make breathing a little easier. “We try to help patients identify which areas are a little tense and we work on that,” Marlow says.
In addition to gentle stretching, yoga or tai chi can help loosen your muscles and help you relax. The anxiety associated with the struggle to breathe that COPD can present makes everything worse, so finding a way to reduce that stress and anxiety is an important component to your management plan.
The COPD Foundation recommends using pursed-lip breathing (breathing in through the nose and puckering your lips when breathing out slowly through the mouth) to help calm and relax you if you’re having trouble breathing. This type of breathing forces you to slow down and exhale all your air, helping to reduce some of the hyperinflation of the lungs that can result from COPD. Similarly, diaphragmatic or belly breathing in which you use the diaphragm to push the air out of your lungs can also help relax you and reduce the amount of air that’s trapped in the lungs. Ask your pulmonary therapist or a yoga instructor to show you how best to execute these breathing exercises.
Strengthening
“With strengthening, we want to make sure the muscles are efficient,” Marlow says. “We’re trying to use the oxygen that we have as best we can, so we do upper and lower body strengthening. There’s 100 ways to exercise,” he says. Strengthening exercises may include lifting light free weights, working on a weight machine or using stretchy resistance bands. “We use light weights in our program. And we do want to slowly build up. We’ll typically start with maybe 10 repetitions. Over the course of time, we’ll increase the number of repetitions and once we get up to 20 and they maintain that for a week or two, we’ll increase the weight, but decrease the repetitions,” he says.
Strengthening work should be done for both the upper body and lower body, Marlow says, adding that during your rehabilitation program, your therapist will likely show you some exercises you can do at home on your own or at a local health club after the formal pulmonary rehab ends. “Our [exercises] are typically simple things you can do with resistance exercises.” He says lower body resistance exercises may include side leg lifts, heel-to-toe lifts and repetitions of rising from seated to standing positions.
[See: 7 Things You Didn’t Know About Lung Cancer.]
Upper Extremity Endurance
Marlow says improving upper extremity strength and endurance is important to keeping you independent. “Upper extremity endurance allows you to do things above your head,” such as reaching for items on a high shelf or getting dressed, “and makes your daily living skills a little bit easier.” He says many patients use a machine called an arm ergometer — a small, tabletop bicycle that’s pedaled with the arms. Patients will typically “circle one way and then back the other for 10 to 15 minutes, and the idea is to just build your upper body endurance.” He says resistance bands can be used to mimic the motion if you don’t have an arm ergometer at home. In addition, “we do a series of arm movements where they continue to move their arms in different directions to build up that upper body endurance that way.”
Lower Body Endurance
Marlow says lower body endurance exercises are the “cornerstone” of a pulmonary rehabilitation program and critical for COPD patients to engage in regularly after the formal program ends. “It’s the most important part, I think,” because without lower body endurance, it’s difficult to get around to do all the things you need to do every day. Lower body endurance exercises include things like walking, riding a stationary bike, cycling or using a modified elliptical machine that works both the legs and the upper body.
Marlow also recommends water aerobics or running in the pool, and he says some patients who are on oxygen will set their tank at the edge of the pool and do water aerobics while tethered to the oxygen. Depending on the stage of your COPD, you may want to consider adding some swimming. In his program, Marlow says patients will often begin exercising on a bike or walking slowly on a treadmill or around a room, so they can stop to rest if they need to. “But we also try to always get patients to walk as much as possible because that’s what you use for everyday life.”
[See: 7 Lifestyle Tips to Manage Your Asthma.]
Start Slowly and Build Gradually
Lastly, it’s important to remember that if you’ve been mostly inactive for a while, you should ease back into a regular exercise routine. Start out slowly and build gradually to allow your body time to adjust to the new regimen. “We don’t want to increase more than 10 percent every week or two,” Marlow says. And find something you’ll enjoy doing long-term. “We want it to be a lifestyle change where you’re doing this regularly.”
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What Are the Best Forms of Exercise for COPD Patients? originally appeared on usnews.com
