Individuals with COPD will be affected by shortness of breath during exercise at some point of the condition’s progression. Because of this, they will begin to do less and less. They will begin to reduce actively engaging in activities and eventually will then become too weak to do things that they once enjoyed. This is called progressive de-conditioning. De-conditioning is losing fitness from lack of exercise.
It’s normal during light to moderate exercise you become short of breath with COPD. When the exercise however is completed safely and correctly, it can surprisingly help to manage this shortness of breathing once limiting them from activities.
You are probably wondering how you get started. This blog is here to help you answers some questions you may have about exercising with your condition. Lets first start by looking at how you get a hold of your breathing.
Breathing strategies to match your breathing to your effort
There are two techniques commonly used by individuals with COPD to manage their shortness of breath, these are called pursed lipped breathing and belly (diaphragm) breathing. This techniques at first can be challenging to get the hang of and you may benefit from seeing a physiotherapist to ensure you are completing t
he technique safely and correctly.
Pursed lipped breathing: This technique should be used during and after exercise to reduce the sensation of breathlessness. It works by breathing in nice and deep through your nose. When breathing out you want the breath to be slow and not forceful. Your mouth opening should be narrow and pursed like you were blowing out candles. It is important that your breath out is 2×3 longer in time than your breath in.
Belly (diaphragm) Breathing: Belly breathing works by placing one hand on your abdomen. As you breathe out then you should feel your diaphragm flatten and lower. The opposite happens on your breath in. As you breathe in you should be able to feel the rise of the diaphragm into your hand. The best time to practice this exercise when you are relaxed and rested. Practice 2/3 x day for 5 to 10 minutes. Start initially practicing in lying then progressing to harder positions such as sitting, standing then during activities.
How do I Start an exercise program?
First all of speak to a doctor or health care professional to get the all clear to exercise.
From there, If you are feeling short of breath during your daily activities, you will need to begin your exercise program slowly. Your program in this case should be supervised.
If you are relatively active, then you can create a generalised program that will improve your strength. The main goal you should set for your self is creating a program that will improve your ability to be active for longer periods.
What would be considered a good exercise program?
Warm up and stretching: completing this prior to your exercise will prepare you for the work out. It will also help prevent injuries from occurring. Stretching helps your joints move to their full ability without any restrictions. You ideally should stretch 5 times a week at least. You should only ever stretch to the point of mild discomfort. Breathe in while you stretch. Breathe out while you hold the stretch. Ensure you hold each stretch for a minimum of 20 to 30 seconds. Repeat each stretch at least 3 to 5 times. Specific stretches can be given to you by your physiotherapist.
Cardiovascular exercise: The main benefits of performing this type of exercise is increasing blood circulation and oxygen intake which as a result will improve your lung and heart function. There are many ways to do this type of exercise such examples include cycling, running, walking and swimming. You should do this type of exercise once a day, 3 to 5 times per week. You should attempt to progress doing this for 20 or 30 minutes at a time. (Talk with your doctor about how long you should do this type of exercise). Always warm up and cool down at a lower intensity for at least 3 minutes.
Muscle strengthening: This form of exercise is completed using free weights or resistance bands. The main benefit for this form of exercise is to build strength and endurance in your muscles to allow you to complete tasks for longer with less effort. There are muscle strengthening exercises for the upper body and lower body. You should aim do this type of exercise 3 times a week. A goal to work towards would be aiming for 10 repetitions and 3 sets for each exercise. Specific exercises can be tailored to your specific needs by your physiotherapists.
To get the most benefit, you should exercise on a regular schedule. You will receive the most benefit from doing a moderate amount of activity on most, if not all, days of the week. But you will still have some benefit if you only exercise three times per week.
When will I know if I am exercising enough or too much?
World Health Organisation state exercising at a moderate level will help you increase your overall endurance. This means it will help you be able to be more and more active. How do you know what is moderate?
The “Borg Scale of Perceived Exertion with Exercise” can help you decide if you are exercising at a moderate level. “Perceived Exertion” means: how hard you think you are exercising. This scale can help you decide how well you are exercising. It can also help you stay at a moderate level of activity.
You do not need any special skills or equipment to use the Borg Scale. When you are exercising, try to estimate how hard you think you are working. The scale below is a guideline to how you would rate this.
Borg Scale of Perceived Exertion
- 0: Nothing at all
- 0.5: Very, very weak
- 1: Very weak
- 2: Weak (light)
- 3: Moderate
- 4: Somewhat strong
- 5: Strong (heavy)
- 6: –
- 7: Very Strong
- 8: –
- 9: –
- 10: Maximal (the most you can work)
Ideally you should be exercising at a 3 or 4 level on the scale. You may feel that you cannot adjust your breathing. If however, you feel too short of breath or you may have aches that last longer than 20 or 30 minutes after exercising then reduce your exercise level to a 1 or 2 on the scale.
I hope this blog was able to assist you in getting started on your journey to exercise. If you are wanting further guidance with exercising, book in today with one of our friendly physiotherapists and you will be tackling those stairs in no time.
Brooke Lavell
Physiotherapist
