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CPPD - The Importance of Exercise

Author  Dr. Karl Knopf, EdD


Breathing comes natural and therefore is something we take for granted, but this simple process of inhaling and exhaling keeps us alive. The primary function of the lungs is to extract oxygen from the air and deliver it to the blood stream, and to remove carbon dioxide from the blood stream.  For the average person, breathing occurs over 6 billion times a year.  However, COPD can make it increasingly difficult to achieve this life-giving task.

What is COPD?

Chronic obstructive pulmonary disease (COPD) refers to a group of lung diseases that block airflow. Emphysema and chronic bronchitis are the two main conditions that make up COPD, but it can also refer to damage caused by chronic asthmatic bronchitis. Symptoms of COPD develop slowly over several years.  In general, symptoms of COPD don't appear until significant lung damage has occurred, and they usually worsen over time. People with COPD are also likely to experience episodes called exacerbations, during which symptoms suddenly get much worse.

Signs and symptoms of COPD can vary, depending on which lung disease is most prominent. It's also possible to have many of these symptoms at the same time.

  • Morning cough
  • Emphysema
  • Shortness of breath, especially during physical activities
  • Wheezing
  • Chest tightness
  • Chronic bronchitis

From the Mayo Clinic website.


Regular exercise improves breathing function and makes breathing more efficient. Proper exercise helps cleanse the lungs of toxins. Before beginning with a COPD exercise program, be sure to talk with your doctor or other health care provider.

Exercise can provide many benefits for individuals with COPD:

  • Improve how well the body uses oxygen; people with COPD use more energy to breathe.
  • Decrease symptoms and improve breathing.
  • Strengthen the heart, lower blood pressure, and improve circulation.
  • Improve energy, making it possible to stay more active.
  • Improve sleep and enhances relaxation.
  • Help maintain a healthy weight.
  • Enhance mental and emotional outlook.
  • Reduce social isolation, if you exercise with others.

It is best to include a variety of activities within your exercise program. Stretching lengthens your muscles, increasing flexibility. Stretching can also help prepare the muscles for other types of exercise, decreasing your chance of injury.  Aerobic exercises use large muscle groups to move at a steady, rhythmic pace. This type of exercise works your heart and lungs, improving their endurance. This helps your body use oxygen more efficiently and, with time, can improve your breathing. Resistance training can improve both muscular strength and endurance. Targeting the upper body can help increase the strength of your breathing muscles. Breathing exercises can strengthen breathing muscles, allowing you to get more oxygen and breathe with less effort.

Here are two examples of breathing exercises you can begin doing for five to 10 minutes, three to four times a day.

Pursed Lip Breathing:

Relax your neck and shoulder muscles.

Breathe in for two seconds through your nose, keeping your mouth closed.

Breathe out for four seconds through pursed lips. If this is too long for you, simply breathe out twice as long as you breathe in.

Use pursed-lip breathing while exercising. If you experience shortness of breath, first try slowing your rate of breathing and focus on breathing out through pursed lips.

Diaphragmatic Breathing:

Lie on your back with knees bent; you can put a pillow under your knees for support.

Place one hand on your belly below your rib cage. Place the other hand on your chest.

Inhale deeply through your nose for a count of three. Your belly and lower ribs should rise, but your chest should remain still.

Tighten your abdominal muscles and exhale for a count of six through slightly pursed lips.

It's good to take precautions when exercising with breathing concerns.

  • Always consult a doctor or other health care provider before starting a program.
  • If shortness of breath becomes severe, stop exercising.
  • If you have a change in any medications, talk to your doctor before continuing with your exercise routine.
  • Balance exercise with rest. If you feel tired, start at a lower level.
  • Evaluate the air quality of the environment before exercising; use caution exercising outdoors when the weather is very cold, hot, or humid.


If you have trouble breathing, such as experienced with COPD, exercise may be the last thing you feel like doing. But exercises can help improve breathing, allow you to stay as active as possible, and improve your quality of life. 



American Lung Association. www.lungusa.org

American Physical Therapy Association. 2003. Guide to Physical Therapists. 2nd edition. Alexandria, VA.

ISSA Fitness Therapy Manual. 2019

John Hopkins White Papers. 2019. John Hopkins Medicine, Baltimore Maryland.

Knopf, K., Gilbert, F. 2013. Principles of Therapeutic Exercise, University Readers, San Diego, CA.

National Heart, Blood and Lung Institute. 2015. COPD. Department of Health and Human Services.



Dr. Karl Knopf has been involved in health and fitness for over 45 years, working in almost every aspect of the industry – from personal trainer and therapist to consultant. While at Foothill College, he was the Director of the Fitness Therapy Program, a teacher of adaptive PE, and recognized with several awards for teaching excellence. For 15 years, Dr. Knopf served as the President and Founder of Fitness Educators Of Older Adults. He has authored many articles, has written over 20 books, and has been a frequent guest on the Sit and Be Fit television show.

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