Living an active life with COPD

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All of our factsheets have been reviewed by members of the European Respiratory Society (ERS) who are experts in the field. These are freely available to download in a range of European languages.

Keeping active when you have Chronic Obstructive Pulmonary Disease (COPD) can be challenging as breathing takes much more energy and effort than normal.

This factsheet is designed for people with COPD and their families and carers. It explains why activity is affected by your illness, why keeping active is important, and how to live an active life with COPD.

What is COPD?

COPD is the general term given to diseases such as emphysema and chronic bronchitis which cause the airways to become permanently blocked or narrowed. The disease mainly affects your lungs and your ability to breathe, but it can also affect your muscles, heart, bones and overall mood amongst other things. Tobacco smoke is the most common cause of COPD in Europe, but a number of other factors can lead to the development of the disease. These include indoor and outdoor air pollution, as well as dust and chemicals in the workplace and existing illnesses such as chronic asthma. Symptoms tend to worsen over time and you may find that you have to slow down when doing normal daily activities such as walking up stairs, shopping, or having a shower. You may sometimes feel unable to carry out these things. Keeping active can help make these tasks more manageable and help you to feel better in general.

Common symptoms:

  • Shortness of breath during exercise
  • Chronic cough
  • Tight chest
  • Wheeze

Why is activity important?

  • Exercise helps everybody stay fit and healthy
  • If a person is fit, breathing is easier and returns to normal more
  • quickly after exercise
  • The fitter you are, the easier you will find daily activities despite your breathing difficulties
  • Keeping fit and active will help you to stay healthy in the future.
“I still do my household work, but I learnt to do it very slowly and spread tasks over several days. People don’t always understand why you are not more active. I learned to pace myself in order to do more. I’d go out for a walk instead and do things I really enjoy. You need to stay active for as long as possible.” Person with COPD

How does COPD affect me?

One of the earliest signs of COPD is finding that you can’t manage activities as easily as you used to. You may find that you need to stop and recover half way up the stairs, or rest during a walk. Symptoms of breathlessness and tiredness tend to become worse over time, however many patients find that their illness varies from day to day. One day you may feel it is easy to manage your breathlessness, and other days it might stop you carrying out any activities at all. Similarly you could wake up in a morning feeling terrible, but your symptoms may improve by the afternoon.

COPD affects everybody differently depending on the severity of your illness. If your condition is mild or moderate, you may start to notice that walking, exercising, shopping and other leisure activities may become harder. If your condition is more severe, activities such as getting dressed, taking a bath or even combing your hair could make you breathless. As with other long-term illnesses which affect usual lifestyle activities, COPD can cause emotional suffering. Depression, sadness and a feeling of losing control or feeling frightened and panicky, are all common emotional side effects of COPD. COPD can also impact upon relationships as many people start to feel dependent on others for assistance with household activities or lonely if going out becomes difficult. Some people also worry about breathlessness during sexual activity. This breathlessness can be alarming and often reduces a person’s urge for sex or their enjoyment of it. It is important not to feel ashamed and to talk about your concerns with your doctor, nurse or physiotherapist.

What can I do about it?

As well as taking regular treatment, you can also reduce your shortness of breath by training and strengthening your muscles so they work better. Being short of breath during activities can be frightening. It can be tempting to avoid exercise that you think will make you breathless. If you are inactive, you will become unfit and your muscles will become de-conditioned. This means they will lose strength and weaken, making physical activities become more difficult. As a consequence, you will need to breathe even more, which will make even simple activities hard. This can also affect your mood and lead to you feeling depressed. You can stop this vicious circle right at the start by keeping active. If you maintain physical activity, your lungs and muscles will keep working as well as they can do, and your health will deteriorate much less rapidly. As well as benefits to your general health, keeping active will also help reduce breathlessness when you exercise, reduce leg tiredness, raise energy levels, improve muscle strength, boost your immune system and improve your self-esteem and mood.

Keeping active according to your level of breathlessness

If you are regularly short of breath, ask your doctor to find out why this is happening. The following tips may help people with COPD to deal with breathlessness during physical activity:

Your level of breathlessness How to keep active
Not troubled by breathlessness except on strenuous exercise
  • Stick to a regular activity plan including 30 minutes of moderate exercise on at least 5 days per week (e.g. brisk walking)
  • Allow enough time to recover after exercise
Short of breath when hurrying or walking up a slight hill

 

  • Plan activities in advance so you don’t have to rush too much
  • If you are short of time, do not panic as this makes breathlessness worse. Keep going steadily, as best you can
  • Consider using your reliever inhaler that is provided by your doctor when you experience symptoms

 

Walk slower than companions on the level because of breathlessness, or have to stop for breath when walking at own pace

 

  • It is okay to be out of breath. Moderate breathlessness is completely safe and just means you are taking good exercise
  • Take slow deep breaths rather than fast shallow breaths
  • Take a rest if you need to and consider taking your reliever inhaler

 

Stops for breath after about 100 m or after a few minutes on the level

 

  • Include lots of rests in your activity
  • Reach your goal in your own time
  • It’s okay to feel out of breath
  • Consult with an expert in COPD and exercise (e.g. a physiotherapist) to see what exercises you can still do to maintain your physical condition
Too breathless to leave the house, or breathless when dressing or undressing

 

  • Tackle one thing at a time
  • Feeling breathless is scary but it is not harmful. Your breathing should return to normal after a few minutes of rest.
  • Use distractions to take your mind off your breathing for 2 minutes until you get your breath back
  • Continue with simple daily activities as much as possible

 

One of the simplest ways to control shortness of breath is to breathe through pursed lips, as if you were going to whistle. If you take deep breaths through the nose and release air through pursed lips, your airways will be open longer, which will help you regain a normal breathing rate.

Depending on how severe your symptoms are and how you prefer to exercise, keeping active ranges from basic activities around the home to structured exercise sessions. A physiotherapist can help you plan activities that are right for you.

You can try to build different activities into your daily routine in order to maintain your level of fitness:

  • Gardening
  • Walking up and down the stairs
  • Getting off the bus one stop early, or taking a short walk
  • Light swimming
  • Keep-fit exercises
  • Stretching routines at home to strengthen your muscles

If you want to improve your fitness, you can go to expert-led exercise training programmes, or pulmonary rehabilitation programmes. Pulmonary rehabilitation involves organised exercises and education about your lungs and keeping healthy, as part of a group. It can be beneficial if you aren’t used to exercise and would like help to gradually build up your activity levels. It can also help build your confidence and your ability to cope with your illness. As your fitness improves, you may then enjoy structured sessions and classes, such as aqua aerobics, yoga and dancing. Talk to your doctor, nurse or physiotherapist about the type of exercise that is right for you and the programmes available in your area.

Things to remember:

  • Always warm up and cool down after exercise
  • Keep water with you to drink before, during and after exercise
  • Keep your medication nearby
  • Don’t push yourself beyond your limits
  • Pursed-lip breathing

Stop the activity you are doing if you feel any of the following:

  • Tight chest
  • Dizzy or sick
  • Clammy or cold
  • Increasing wheeze
  • Pain in your joints or muscles
  • Abnormally tired

Frequently Asked Questions (FAQs)

Is getting out of breath dangerous?

Breathlessness can feel distressing, but increases in heart rate and breathing are normal during exercise, and are not dangerous. Your breathing should return to normal after you stop the activity. If it does not, you should contact your doctor. If you are more short of breath than people of your own age during exercise, you should consult a doctor and ask for advice. They could recommend a training heart rate for you, which will give you the number of pulse beats per minute which you should be aiming for when exercising. There are often simple solutions which can make physical activities more comfortable for you.

Would oxygen help?

Doctors provide oxygen to people based on the level of oxygen in your blood, not on how breathless you feel. You could be very short of breath, but the levels of oxygen in your blood are sufficient and by contrast, some people may need oxygen even though their breathing feels okay. If the oxygen in your blood stream is below a critical level, then you may be prescribed oxygen.

When do I need to see my doctor?

You should see your doctor initially to find out why you are short of breath during exercise and what type of exercise is right for you. You should also see a doctor if your breathing suddenly becomes worse during exercise, or it doesn’t recover soon after you stop exercising.

The PROactive study

The PROactive study is developing a new tool that will help doctors measure activity in people with COPD. The system works by using an electronic recording device, similar to a mobile phone or electronic diary, to record the user’s activities during the day. It will also take information from an activity monitor, worn by a person with COPD, to see if their activity improves after different treatments for the condition. The research team believe the best way to find out about COPD treatments is to ask people with the condition about their quality of life. Researchers are currently studying hundreds of people with COPD across Europe to see what activities they are doing, what treatments they would like to see in the future, and how they feel when they exercise with their condition. The new tool will be developed based on these answers. If you’d like any information on the outcomes of the study, or if you have a question about the project, please email: [email protected]

 

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Authors

This material was written by the ELF in conjunction with the PROactive project, part of the EU Innovative Medicines Initiative.

The PROactive project aims to develop a tool that will help doctors assess how activity impacts the lives of people with COPD. For more information on the project and to keep up to date with their findings, visit the PROactive website.

Interesting links

Visit the COPD section for more detailed information
Read our other factsheet on Living Well with COPD
For more information about the PROactive project,

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