Exercise Therapy - Pulmonary Rehabilitation: Smoking Cessation

Content provided by the Faculty of the Harvard Medical School

Exercise therapy

Everyone in pulmonary rehabilitation gets aerobic exercise therapy under the supervision of a health care professional, usually a physical therapist or exercise physiologist. The purpose of aerobic exercise is to increase your endurance and strengthen your muscles to lessen your symptoms and improve your tolerance for activity.

Exercise therapy usually involves walking on a treadmill or cycling on a stationary bicycle. The particular exercises you do will depend on your tolerance for exercise and the condition of your joints, bones, and muscles. Also important are the types of exercise you enjoy, whether you have access to any exercise equipment, and whether you are able to exercise independently or need regular monitoring. If your breathlessness is so severe that you can't walk, you may start off on a stationary bicycle or making cycling motions while seated in a chair. If you can walk but have little endurance, you may use the treadmill with the goal of increasing the time and intensity of your workout. Sustained periods of exercise usually last for 20–45 minutes, but many people initially require periods of rest interspersed with periods of exercise, an approach known as interval training.

Many rehabilitation programs also offer strength and flexibility training. Weakness in the arms, legs, and trunk muscles is a common problem in people with COPD and one of the main factors that limits their physical activity. Strength training may be done by lifting weights, using weight machines, or pulling on elastic bands. Flexibility training consists of stretching exercises. A European study found that patients who had strength training for their arm and leg muscles were able to walk farther than patients who did not have this training.

Exercise therapy as a whole has many benefits, according to an analysis of several trials published by the American College of Physicians in 2003. The analysis found that patients who had exercise therapy experienced less shortness of breath and fatigue, had greater exercise capacity (they could walk farther, for example), could do more day-to-day activities, and felt better emotionally. But the benefits last only as long as you keep doing the exercises — and that means for the rest of your life.

Making the transition to exercising on your own is one of the most important aspects of your rehabilitation. Some pulmonary rehab programs run a maintenance program in which, for a small fee, you can attend perhaps once a week and exercise in the presence of a health professional who can assess your progress. Even if such a program is not available, it is imperative for you to continue exercising on your own — either at a local facility, such as a gym or community center, or at home.

Many people do not own exercise equipment at home because they lack the necessary space or money. If this is your situation, try the alternatives suggested in Table 3.

Last updated:	May 23, 2007