What is Chronic Obstructive Pulmonary Disease and how can exercise help?

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What is Chronic Obstructive Pulmonary Disease (COPD)?
Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term for a cluster of lung conditions which include Emphysema, Chronic Bronchitis and Chronic Asthma. These conditions cause narrowing of the bronchial tubes (tubes that carry air to the lungs) which can make it hard and difficult to breathe.

Smoking and air pollution are currently the most common causes of COPD. Having COPD also places and individual at greater risk of developing other health conditions. Common methods to improve symptoms include avoiding smoking, avoiding exposure to air pollution, undergoing oxygen and pulmonary rehabilitation, and taking medication. Whilst COPD is uncurable, early treatment and diagnosis may help individuals manage their condition and ultimately breathe better.  

Common symptoms associated with COPD
Individuals are often diagnosed with COPD from mid-life onwards. As COPD becomes worse individuals may find it more challenging to complete their normal activities of daily living. The most common symptoms of COPD include breathlessness and difficulty breathing, chronic cough (either with or without phlegm) and feeling tired and fatigued.

At times individuals can experience flare ups, which occur when COPD symptoms become worse. These flare ups usually last for 2 – 3 days and will require medication to treat.

Individuals with COPD are at a higher risk of developing other chronic health conditions which include.

• Depression
• Anxiety
• Cardiac concerns
• Lung infection and cancer
• Flu or pneumonia
• Weak muscles and brittle bones

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Severity of COPD
Like with most chronic health conditions, there are different severities and different diagnostic criteria for each. The below definitions may be useful to help understand the diagnostic criteria for the different severities of COPD.

• FEV1 = the amount of air that can be forced out of your lungs within 1 second
• FVC = the total amount of air that can be forced out of your lungs
• Bronchodilator = medications (usually administered via a puffer) that relax and open the airways in the lungs 

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How is COPD diagnosed?
There are multiple types of tests that are used to diagnose COPD. Specifically, lung tests that test breathing (which is known as spirometry) is the most common assessment that is used to diagnose COPD. These assessments assess how much air you can breathe in and out of your lungs as well as how stretchy your lungs are (e.g how quickly you can forcefully expel air from your lungs).
Other assessments that may be performed include:

• X-ray: takes images of the lungs and the surrounding organs
• CT scans: takes images of the lungs and surrounding organs at a greater detail than x-rays
• Arterial blood analysis: determines how well your lungs are able to bring oxygen into the blood and remove carbon dioxide
• Laboratory tests: used to rule out the diagnosis of other conditions

 
How does exercise benefit those who have been diagnosed with COPD?
Like with many health conditions, multiple health benefits are achievable when participating in exercise that is specifically tailored to the individual. The below benefits can be viewed below.
Exercise can increase

• Energy levels
• Cardiovascular fitness
• Immune strength
• Muscle strength and endurance
• Sleep quality and duration
• Bone mineral density
• Reported self-confidence, self-esteem and body image

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Exercise can decrease

• Breathlessness and the sensation of being out of breath
• Risk factors for the development of other disease
• Blood pressure
• Cholesterol
• Medication side effects
• Hyperinflation – when the lungs expand upon their normal size
• Feelings of depression and anxiety
• The amount of air (or ventilation) required at a given work rate  

Things to consider when exercising with COPD

• Monitoring peripheral oxygen saturation levels using a pulse oximeter. Peripheral oxygen levels ≤ 88% is a contraindication for exercise.
• Managing breathlessness. The recommendation is nasal breathing on inhalation, pursed lips breathing during exhalation.  
• Managing fatigue levels. Often people with COPD may experience early onset fatigue due to reduced oxygen to muscles.

Exercise recommendations for those with COPD
According to the most recent research, the below is the evidence-based exercise recommendations for those who have been diagnosed with COPD.
Frequency

• Aerobic: 1-2 sessions, 3-5 days per week
• Strength: 2-3 days per week
• Flexibility: 3 or more days per week, preferably on days that aerobic or strength exercise is performed

Intensity

• Aerobic: 40 – 80% of maximal effort (modified borg 2 – 4)
• Strength: 60 – 80% of maximal effort (modified borg 3 – 4)
• Flexibility: low to moderate, depending on capability and function

Time

• Aerobic: 30 minutes, broken into smaller durations if necessary due to symptoms
• Strength: 1 set of 8-12 reps, 8-10 exercises or 30 – 40 minutes
• Flexibility: 30 seconds minimum for each static stretch

Type

• Aerobic: walking, cycling, swimming
• Strength: free weights, therabands, inspiratory muscle training, body weight exercise,
• Flexibility: stretching, tai chi, yoga

 
Written by - Rebecca Dostan: AES, AEP, ESSAM

 References
Exercise is Medicine 2024, Chronic Obstructive Pulmonary Disease (COPD) and exercise, viewed 16 October 2025, <2014-COPD-FULL.pdf (secureserver.net)>.

Lung Foundation Australia 2024, Overview – Chronic Obstructive Pulmonary Disease, viewed 11 October 2024, <Overview - Chronic Obstructive Pulmonary Disease (lungfoundation.com.au)>.

Lung Foundation Australian 2024, Exercise Prescription – A reduction in exercise tolerance is one of the main complaints of people with chronic lung disease, viewed 18 October 2024, <Exercise Prescription and Training | Pulmonary Rehabilitation Toolkit>.

World Health Organization 2024, Chronic obstructive pulmonary disease (COPD), World Health Organization, viewed 15 October 2024, <Chronic obstructive pulmonary disease (COPD) (who.int)>.