Optimizing Exercise with Oxygen Therapy and COPD

Learn about exercise with oxygen therapy, exercise for copd, exercise and copd

Exercise and COPD

When you have a health condition that affects your breathing, exercise is probably the last thing on your mind. But studies show that, when you have COPD, regular physical activity relieves shortness of breath,1 decreases anxiety, reduces fatigue, promotes greater independence, and improves overall quality of life.2 In addition, supplemental oxygen therapy administered during exercise enables people with lung disease to exercise at higher levels of intensity,3 and improves performance both before and after exercise.4

The Consequences of Inactivity

The hallmark symptom of COPD is progressive shortness of breath. As breathlessness worsens, many people adopt a more sedentary lifestyle. Over time, prolonged inactivity negatively impacts the ability to function normally. As inactivity persists, the heart and circulatory system are affected and muscle strength declines, creating a vicious cycle of increased breathlessness, muscle fatigue, loss of independence, depression, and social isolation.2

How Much Exercise do you Need?

How much exercise is needed to prevent the progressive deterioration that occurs with inactivity? The American College of Sports Medicine suggests that light to moderate exercise at least 30 minutes a day on most, if not all days of the week is optimal.

Many people aren’t able to exercise anywhere near that long, especially in the beginning. If daily, 30 minute sessions present too great a challenge, try 15 minutes of moderate activity 3 days a week. Experts agree that this is the minimum amount needed to obtain the greatest health benefits out of an exercise program.2

What about Co-Existing Heart Conditions?

Some patients have co-existing illnesses like high blood pressure and heart disease that make physical activity even more difficult. If this applies to you, an exercise tolerance test administered under medical supervision is recommended to assist your doctor in determining an exercise program that’s safe and appropriate for your current level of fitness. If your doctor determines that exercising on your own is not advisable, enrolling in a medically supervised, pulmonary rehabilitation program may be your best option.2

Managing Shortness of Breath during Exercise

If your doctor determines that you’re stable enough to exercise on your own, you may wonder if it’s safe to continue your session once you’ve become moderately breathless. Ideally, how hard you work during exercise should not be limited by moderate breathlessness. Short intervals of exercise with regular rest periods should allow you to complete a session, without having to stop completely.  Because moderate breathlessness during exercise is usually temporary, slowing down rather than stopping suddenly is your ultimate goal. Of course, if your breathing becomes increasingly labored, you should stop and rest.2

Optimizing Your Medications Before and During Exercise

Before you begin, talk to your physician about timing your prescribed medications to optimize your exercise sessions. For example, using a bronchodilator inhaler shortly before, and during exercise (if you need it), relaxes the airways making it easier to breathe during periods of exertion or breathlessness. Routine, inhaled corticosteroids reduce airway inflammation, allowing air to flow more easily to and from the lungs. Mucolytics (medications that thin secretions) used prior to exercise help facilitate airway clearance, ridding the lungs of excess mucus that may block your breathing passages. Finally, performing pursed-lip breathing throughout your exercise session will help you better manage your breathlessness with the least amount of anxiety.2

When to Stop

The guidelines for when to stop exercising apply to anyone, not just people with chronic health conditions. Stop exercising and seek medical advice for any of the following symptoms:2

  • Nausea
  • Persistent headache
  • Lightheadedness or dizziness
  • Pressure or pain in the chest, neck, arm, or jaw
  • Labored breathing that doesn’t go away with prescribed medications or rest

For more exercise tips, read: 11 Tips for Exercising with a Chronic Lung Condition.


Author: Deborah Leader RN, BSN, PHN


1 R Garrod, E Paul, and J Wedzicha. Supplemental oxygen during pulmonary rehabilitation in patients with COPD with exercise hypoxaemia. Thorax. Jul 2000; 55(7): 539–543. doi:
2 American College of Sports Medicine. Exercise for Persons with Chronic Obstructive Pulmonary Disease. Accessed June 11, 2014.
3 Margareta Emtner, Janos Porszasz, Mary Burns, Attila Somfay, and Richard Casaburi. Benefits of Supplemental Oxygen in Exercise Training in Nonhypoxemic Chronic Obstructive Pulmonary Disease Patients. American Journal of Respiratory and Critical Care Medicine, Vol. 168, No. 9 (2003), pp. 1034-1042. doi: 10.1164/rccm.200212-1525OC.
4 Rooyackers JM1, Dekhuijzen PN, Van Herwaarden CL, Folgering HT. Training with supplemental oxygen in patients with COPD and hypoxaemia at peak exercise. Eur Respir J. 1997 Jun;10(6):1278-84.Photo Credit: Flickr, Treadmill

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