Your Exercise Treatment for Lung Disease

Barry D. Mink, MD

Series Editor: Nicholas A. DiNubile, MD

THE PHYSICIAN AND SPORTSMEDICINE - VOL 25 - NO. 11 - NOVEMBER 97

For Comfortable, Enjoyable Exercise

Wear good supportive shoes and loose, comfortable clothing that enables you to move and breathe easily.
Exercise in a well-ventilated, unconfined environment.
Exercise with others: Like-minded friends encourage each other and feel more secure when working out together.

Exercise is a vital part of your treatment for lung disease. By following a regular training program, you will increase your endurance and become stronger and better able to perform the activities of daily life. Shopping, cleaning, and just moving about will become easier and more comfortable. You will be less troubled by shortness of breath, your spirits will lift, and you'll sleep better. In short, you'll enjoy life more. Exercise also has general health benefits, such as protection against heart disease, high blood pressure, high cholesterol, and excess weight gain.

Before You Start

Before prescribing a program, your doctor will probably want to determine your capacity for exercise by closely observing you on a treadmill or stationary exercise cycle. He or she will watch your heart, lungs, and blood oxygen levels carefully to establish a safe exercise level for you. You will very likely start the program itself under supervision, so you will learn how to work out safely and efficiently.

The best exercises are aerobic activities that get your heart pumping faster: Walking or using the stationary exercise cycle are ideal because they work the largest muscles in the body. Swimming (or calisthenics in the water), aerobic machines like a stairclimber, and arm exercises can also be helpful. You and your doctor should work together to determine what activities are most comfortable and effective for you.

It is important that the exercise program be tailored closely to your needs. If you require supplementary oxygen, it will be available. Medications like inhalers to help open your airways can be used if necessary.

Getting Into the Program

For maximum benefits, it's best to walk or pedal at a rate that raises your heart rate to 60% to 80% of its maximum (a number determined by testing), for 20 to 30 minutes, 3 days a week. It may take weeks or months to get there, or you may never reach this level at all.

But that's all right—the main goal is to improve your ability to exercise, and any improvement is beneficial. Most lung patients make substantial gains: In 6 weeks, it is not uncommon to see a 70% to 80% improvement over your initial ability.

Here are some guidelines to follow as you start to exercise:

Start slowly: If you can only walk (or cycle) for 2 minutes at first, do that. There's no rush. Find a pace that's right for you, and improvements will come. Your doctor will help you set appropriate personal goals.
Be consistent: Even modest workouts will bring noticeable benefits—if you keep them up conscientiously. But if you exercise fewer than three times a week, it is unlikely to help very much.
Break up sessions: If you can only walk for 5 minutes at a time, schedule two sessions (no more than that) on your exercise days.

Big Bonus: Less Worry

Shortness of breath (dyspnea) is a problem for almost everyone who has lung disease. You're bound to experience it when you exercise. Keep in mind that if you're following a program designed for you, dyspnea isn't dangerous. One of the big benefits of exercise will be your growing ability to tolerate some shortness of breath without anxiety.

Remember: This information is not intended as a substitute for medical treatment. Before starting an exercise program, consult a physician.

Dr Mink practices medicine in Aspen, Colorado, is a fellow of the American College of Physicians and the American College of Sports Medicine, and has been a team physician at the 1980 and 1994 winter Olympics and for the US biathlon team. Dr DiNubile is an orthopedic surgeon in private practice in Havertown, Pennsylvania, and is the director of Sports Medicine and Wellness at the Crozer-Keystone Healthplex in Springfield, Pennsylvania.

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