Chronic Respiratory diseases include Chronic Obstructive Pulmonary Disease (COPD), Interstitial Lung disease (ILD), bronchiectasis, asthma, cystic fibrosis. Exercise is recognised as a key non- pharmacological treatment for patients with chronic respiratory diseases. All the clinical practice guidelines strongly recommend exercise training for patients with chronic lung diseases, defining it as the cornerstone of pulmonary rehabilitation.
Effects of exercise on breathlessness: improving or worsening?
Patients with chronic lung diseases avoid activities that make them breathless. However, reduced activity levels can aggravate their breathlessness, creating a vicious cycle that worsens over time. Engaging in regular exercise can help break this cycle and improve their overall condition. Exercises improve strength and stamina, which in turn reduces how patients perceive their breathlessness. As a result, they become more active, breaking the cycle of inactivity and breathlessness. (see Figure 1)
... reduced activity levels can aggravate their breathlessness, creating a vicious cycle that worsens over time.
Figure. 1. Effects of exercise on breathlessness
Other benefits of exercise:
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Reduces the frequency of flare ups and hospitalisations.
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Reduces stress, anxiety, depression and improves your mood.
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Boosts your confidence by making you more active and independent.
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Adds life to years.
Types of exercises:
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Aerobic exercises: Aerobic exercises comprise of walking, cycling, jogging, swimming. These exercises improve stamina and allow to continue activities for longer duration without getting fatigued or breathless.
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Strength exercises: These exercises are performed using various equipments like dumbbells, weight cuffs, therabands, gym workout machines or simply with person’s own body weight. Body’s large muscle groups are targeted. Strength exercises make the muscles stronger and more fatigue resistant.
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Breathing exercises: Various deep breathing exercises, pursed lip breathing technique constitute important part of exercise regimen for patients with lung diseases. They help to improve breathing capacity.
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Flexibility exercises: These are stretching exercises. They ensure optimal flexibility of muscles and reduce risk of injury.
Exercise session of 45 mins to 1 hour is generally advisable for patients with chronic lung diseases. It should begin with 10 mins warm up of low intensity exercises and conclude with 5 mins cool down mainly comprising flexibility exercises.
Safety of exercise:
Exercises are safe for you even if:
You have a severe disease on Pulmonary Function Test (PFT): Patients with mild moderate and severe – very severe disease can safely benefit from exercise.
You are too breathless to leave bed or can just move around for self-care activities: Set of specific, simple exercises are safe. These should be progressed to difficult ones gradually.
You are on oxygen therapy: Exercises are safe when done with the oxygen and meticulous monitoring of oxygen saturation.
Discharged from hospital recently: Exercises are safe and hasten your recovery.
Points to remember:
Exercise is not an alternative to medication; however, it serves as excellent adjunct.
Consult your chest physician before starting exercises. He will determine your suitability for exercises and will put you on optimal medical therapy.
Consult a pulmonary rehabilitation physiotherapist. They will design the most favourable exercise program for you.
Exercise is not one size fits all. Do not self-prescribe exercises. This can be hazardous.
Report to your health care provider in case you have any discomfort with exercises.
References:
Xiong T, Bai X, Wei X, Wang L, Li F, Shi H, Shi Y. Exercise Rehabilitation and Chronic Respiratory Diseases: Effects, Mechanisms, and Therapeutic Benefits. Int J Chron Obstruct Pulmon Dis. 2023 Jun 19;18:1251-1266. doi: 10.2147/COPD.S408325. PMID: 37362621; PMCID: PMC10289097.
Your lungs and exercise. Breathe (Sheff). 2016 Mar;12(1):97-100. doi: 10.1183/20734735.ELF121. PMID: 27066145; PMCID: PMC4818249.
Am J Respir Crit Care Med Vol. 200, P22-P23, 2019 ATS Patient Education Series © 2019 American Thoracic Society
“Importance of exercise in chronic lung diseases.” 2018-2024 Chest Heart and Stroke Scotland and The University of Edinburgh, https://www.respelearning.scot/topic/topic/topic-3-treatment/40/pulmonary-rehabilitation-pr/importance-exercise-chronic-lung