Chronic respiratory diseases (CRDs), such as asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung disease (ILD), affect lung function, making it harder to breathe. Though individuals with CRDs might become more sedentary due to their symptoms, low levels of physical activity can decondition skeletal muscles, leading to increased breathlessness, and leg muscle deconditioning can cause leg fatigue and discomfort.¹ In those with asthma, avoiding exercise can result in chronic deconditioning and lower cardiorespiratory fitness than those without asthma.² In contrast, people with CRDs who perform regular physical activity exhibit improved exercise tolerance, lessened disease symptoms (e.g., labored breathing), increased ability to perform tasks of daily living, and enhanced quality of life.^2–4 Furthermore, exercise promotes blood flow to the lungs and heart, which improves oxygen delivery to the muscles.^4,5

For individuals with COPD, exercise, particularly strength training, is one of the best tools to improve muscle function and quality of life.^2,6 Many patients with COPD have comorbidities, such as hypertension, Type 2 diabetes, and/or cardiovascular disease, but research has shown that exercise training is beneficial, regardless of presence of comorbidities.⁶ Exercise also improves all-cause mortality in those with COPD.² For individuals with ILD, research suggests that participating in pulmonary rehabilitation programs, which provide patients with exercise training along with education and support,⁷ can improve exercise tolerance, strength, and health-related quality of life.⁸

People with CRDs should practice a combination of aerobic and strength training. Experts recommend aerobic exercise 2 to 5 days per week for about 20 to 30 minutes per session and strength training 2 to 3 days per week with 2 to 3 sets of 8 to 15 repetitions.^1,9 For those who cannot tolerate continuous aerobic training or who experience extreme exercise-induce oxygen depletion, interval aerobic training is an option.⁹ Examples of aerobic exercise include walking, cycling, and swimming. Examples of strength training include weight training machines, free weights, and bodyweight exercises targeting both arms and legs. Individuals should aim to perform exercises at a load that they can maintain for 8 to 15 repetitions while still experiencing muscular exhaustion by the end of the repetitions.^1,9

Individuals with CRD should take certain precautions before exercising. They should avoid exercising outdoors when the air quality is poor. Some individuals might need to use an inhaler prior to exercising to prevent breathing difficulties.^5,7 Those with asthma can reduce their risk of exercise-related adverse events through disease control.^2,3 

When exercising, individuals with CRD (and supervising professionals when applicable) should continually monitor their condition.² Exercise should be stopped if any adverse symptoms, such as shortness of breath, chest pain or discomfort, tightening or pressure in the chest, unusual aching or joint pain, nausea, or lightheadedness occur, and a healthcare professional should be immediately consulted.⁴

TIPS

• Always perform warm ups and cool downs before and after exercising.
• Find a workout buddy who will join you in physical activities.
• Stay hydrated, especially while exercising.
• Don’t forget to stretch after each workout.

SOURCES

1. Fierro-Carrion GA, Mahler DA. Exercise prescription for patients with chronic lung disease. Clin Pulm Med. 2002;9(1):1–5. 
2. Physiopedia. Physical activity and respiratory conditions. https://www.physio-pedia.com/Physical_Activity_and_Respiratory_Conditions. Accessed 4 May 2023.
3. Burr JF, Davidson W, Shephard RJ, Eves N. Physical activity in chronic respiratory conditions: assessing risks for physical activity clearance and prescription. Can Fam Physician. 2012;58(7):761–764. 
4. My HealtheVet. Exercise to build healthy lungs. Updated 27 Oct 2022. https://www.myhealth.va.gov/mhv-portal-web/ss20181019-build-healthy-lungs. Accessed 4 May 2023.
5. American Lung Association. Being active with asthma. Updated 28 Nov 2022. https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/managing-asthma/asthma-and-exercise. Accessed 4 May 2023.
6. Spruit MA, Burtin C, De Boever P, et al. COPD and exercise: does it make a difference? Breathe (Sheff). 2016;12(2):e38–e49. 
7. Sockrider M, Corn J. Exercise with lung disease. Am J Respir Crit Care Med Vol. 2019;200(12):P22–P23. 
8. Mendes RG, Castello-Simões V, Trimer R, et al. Exercise-based pulmonary rehabilitation for interstitial lung diseases: a review of components, prescription, efficacy, and safety. Front Rehabil Sci. 2021;2:744102.
9. Gloeckl R, Zwick RH, Fürlinger U, et al. Prescribing and adjusting exercise training in chronic respiratory diseases – expert-based practical recommendations. Pulmonology. 2022:S2531-0437(22)00215-X.