The past several months have been challenging for many people across the world. With the outbreak of the novel coronavirus (COVID-19), most of us are filled with uncertainty about our health and financial well-being. While many people have lost their jobs, older adults, especially those with chronic health conditions like COPD or diabetes, have had to drastically adjust their lifestyle to avoid getting sick.
Last week, we told you seven things that COPD patients need to know about COVID-19. This guide is a great place to start if you want to know the best way to deal with the coronavirus as a COPD patient. In it, you’ll find information about what exactly the new virus is and why it’s so important for respiratory patients to take extra precautions when it comes to social distancing, sanitation, and sheltering in place.
One important point we discussed in this article was staying active. Despite most of us being in our homes all day and night, exercise remains a key part of treating respiratory conditions like chronic obstructive pulmonary disease. However, contrary to popular belief, you don’t necessarily need to get out of your house in order to exercise effectively.
In this post, we’ll take a look at six tips you should know before exercising at home. While these can act as guidelines to get you started, it’s strongly recommended that you first speak with your doctor or pulmonologist to learn what exercise routines are best for you. In the meantime, if you have any questions for us, don’t hesitate to leave them in the comment section at the bottom of the page or fill out the contact form at the side of the page.
Practice Good Posture
Good posture is paramount not only for exercising, but for managing COPD symptoms in general. Posture simply means the way that you hold and carry your body throughout the day. Someone with bad posture may experience back pain, fatigue, or other adverse symptoms, while someone with good posture will avoid any unnecessary and excessive strain on their body.
As we age, it becomes increasingly difficult to maintain a good posture. When we become weaker, we begin to reinforce bad habits that we’ve developed over the course of our life, so late adulthood is a great time to reevaluate the way we sit, stand, and even walk. According to this Harvard report, poor posture can lead to muscle weakness, spasms, and put stress on your neck and lower back. Over time, it can even impair your ability to exercise which is the very goal you’re trying to accomplish in the first place.
Fixing a bad posture is something that you’ll have to actively work at and it’s not something you can necessarily fix overnight. However, by taking things one step at a time, you’ll be able to reverse bad habits that you’ve developed over the course of your life.
The first sign of incorrect posture is a forward neck. This happens when someone pushes their head and neck forward away from their center of gravity and usually develops in people who use their computer frequently. This also occurs more commonly in people who are hard of hearing because they find themselves leaning forward to hear a sound more acutely.
The key to fixing a forward neck posture is to strengthen your upper thoracic extensors. These are the muscles that help keep your head aligned with your shoulders. One way to do this is with chin tucks. Each morning you wake up, roll your shoulders back and drop them. Then press your chin gently backwards. Repeat this several times a day and you’ll notice your neck muscles getting stronger.
Another way to fix this posture is to change the way you sit at a desk. If you use a computer or laptop frequently, try raising it up so that it’s at eye level. If it’s below eye level, you may be tempted to bend over to view the screen. You can also try using a standing desk or using a chair that has support all the way up your back.
Also known as a “hunched” back, postural kyphosis is a leading cause of back pain, stress, and most relevant to COPD patients, breathing difficulties. While so many people struggle with a hunched back, it's very unnatural for our bodies to be in this position. It causes an enormous amount of stress in the spine, pinches nerves in the back, and compresses the lungs preventing us from getting a full breath.
One simple way to fix this is to stand with your back against the wall. Ensure that your heels are as close to the wall as possible and hold your head up straight looking forward. Drop your shoulders and let them roll backward. You should feel your spine center and start to rest in a more natural position. If you notice your back starting to slouch throughout the day, practice this exercise to reset your posture.
Standing and Walking Posture
Unfortunately, the aforementioned tips won’t do you much good if you don’t apply them to the way you stand and walk as well. As we age, standing and walking can become difficult enough as it is due to conditions like osteoporosis or muscle weakness, so a poor posture will only make this more difficult. In general, the same rules apply as when you’re sitting like a straight back and your head being aligned over your shoulders, however, there are some additional points to take note of.
First and foremost, you should be using decent shoes that have good arch support and shock absorption. Tennis shoes are typically the best option but other types of shoes are an option if they follow these guidelines. Another way to ensure you have a great posture while walking is to act like there are balloons attached to your head and chest while your shoulders are able to drop backwards freely. This may feel awkward at first, but eventually you’ll develop a natural way of doing it.
Another way people develop poor posture while walking is if they carry heavy objects like backpacks, purses, or oxygen concentrators. While it’s recommended that older adults avoid carrying heavy objects, if you need to, make sure you’re doing it properly. If you use a backpack, make sure the straps are pulled tight enough that the majority of the weight is held as closely to your back as possible. Doing so will ensure that you don’t experience any unnecessary back strain.
If you’re a COPD patient who needs to carry oxygen with you while you’re out and about, it’s best to find a carrying method that won’t hurt your back. Portable oxygen tanks can weigh over 8 pounds and continuous flow oxygen concentrators can weigh over 15 pounds, so generally you’ll need to use a rolling cart or carry them in a specially designed backpack. Pulse dose oxygen concentrators, on the other hand, are much lighter (under 5 pounds) and can be carried on one shoulder without ruining your posture. Check out this great guide for finding the best portable oxygen concentrator for seniors or fill out the contact form at the side of the page and we’ll get back with you.
Practice Breathing Exercises
Once you’ve fixed your posture, practicing breathing exercises is a great next step towards staying active during the pandemic. As a COPD patient, breathing correctly is very important, and not unlike posture, it is possible to develop bad breathing habits throughout your life. We’ve discussed this topic in depth in a previous post, but if you want a condensed version, we’ll cover it here.
One of the biggest problems COPD patients face is something called “shallow” or “chest” breathing. This is a type of breathing that is primarily done through the use of intercostal muscles the muscles found in between your rib cage. This is a problem because it limits your air intake and it can be painful or difficult for someone with a chronic lung disease because it emphasizes the use of chest muscles which are often weak in these patients.
Alternatively, COPD patients should practice what’s called “deep” or “diaphragmatic” breathing. As opposed to using chest muscles, this type of breathing uses the sheet of muscle below the lungs called the diaphragm. Learning to master this type of breathing can be difficult, but it’s well worth it for someone who wants to breath more comfortably and freely.
Pursed Lips Breathing
Pursed lips breathing is a breathing exercise that’s used to make your breaths slower and more intentional. It’s also designed to give you more control which is ideal for people who want to improve their athletic performance or cope more effectively with respiratory ailments like cystic fibrosis or chronic obstructive pulmonary disease.
To practice pursed lips breathing, lie on your back or sit with your back straight. Drop your shoulders and try to eliminate tension within the body as much as possible. Inhale through your nose for 2 seconds letting your lungs fill with air. Then, purse your lips and blow out slowly for about 4 seconds. Continue to practice this exercise several times each day.
While this may seem like a rather simple and ineffective breathing exercise, studies have shown that it can significantly improve exercise tolerance, arterial oxygen, and breathing patterns, especially in those with declining lung function. This study even found that pursed lip breathing can reduce dynamic hyperinflation in patients with low peak expiratory flow (PEF). Another reason to practice pursed lips breathing is that it can calm your nerves and make you more relaxed. This can help relieve stress and anxiety which are common among COPD patients.
Breathing is part of what’s called the autonomic nervous system. What this means is that it’s a function that your body does without you having to think about it. Your heart rate, blinking, and your breathing rate are all controlled by the autonomic nervous system. Coordinated breathing refers to breathing that you consciously try to control while you’re exercising.
Whenever you lift a heavy object or do some type of strenuous exercise, you may notice that you tend to hold your breath for a second or two or otherwise alter your breathing in some way. While this may be harmless to some people, to someone with COPD, it could cause a significant amount of tension and stress to build up in the chest.
If you’re lifting a dumbbell or some other type of weight, for example, inhale slowly before lifting the weight and start exhaling as you lift the weight. Once you start lowering the weight back down, you can inhale again. This is not only done to help you get a rhythm going and prevent tension in the chest, but it can also improve the strength you gain from the training exercise. Once you master this technique, you’ll also notice that it allows you to recover more quickly from a workout so that you can get back to it the next day.
The diaphragm is a very important muscle in the body. Unfortunately, many people develop bad habits throughout their life that prevent them from using this muscle effectively. If this happens, it’s imperative that you retrain your body to breathe in the most efficient and healthy way possible. This is even more imperative for COPD patients who frequently suffer from muscle atrophy (muscle wasting). Try the following to practice diaphragmatic breathing:
- Lie down on your back on the floor or on a bed. Relax your shoulders and put one hand on your stomach and the other on your chest.
- Inhale for 2 seconds through your nose. If you’re doing the exercise correctly, you should feel your stomach moving more than your chest.
- Slowly exhale with pursed lips and feel your stomach move back downward. Repeat this each day to improve the strength and coordination of your diaphragm.
Practice Endurance Improving Exercises
Lung function is a huge factor in determining your overall endurance. Many COPD patients are unable to run or walk long distances because of problems like low forced expiratory volume (FEV) and total lung capacity. However, by taking the time to create a plan for improving your overall endurance, you’ll be able to do more without adding to symptoms that you may be experiencing.
Typically, pulmonary lung function tests are done in your doctor or pulmonologists office. During this appointment, he/she will perform a number of tests including spirometry, plethysmography, or diffusion capacity tests and gather data about your lung function. Once this is done, your doctor will help you interpret the results and set you up with an exercise plan that best fits your needs. What’s more, you may even be able to track your progress at home using a lung function testing device provided by your doctor. In this case, you’ll be able to track your progress more easily and without having to leave your home.
Aerobic exercise or “cardio” exercise is what you will need to do in order to improve your endurance and lung function as a COPD patient. This includes things like walking, running, hiking, or any other type of activity that gets you moving. Don’t worry though, you won’t have to perform high-intensity exercises to experience the benefits. In fact, many patients are advised not to exercise too much if it will increase your likelihood of experiencing an exacerbation.
Walking is one of the most basic forms of aerobic exercise. And although it likely won’t raise your heart rate too much, it will do enough for you to see noticeable improvement if you stay consistent. When the weather is nice, it’s best to do some walking outside in a park or open space with clean air. However, due to current circumstances with COVID-19, it’s important to follow all your local regulations and wear a face mask. Use this guide by the Centers for Disease Control and Prevention (CDC) on how to wear a face covering correctly.
If you feel unsafe walking outdoors either due to the virus or the weather, there are plenty of options for walking indoors as well. Some COPD patients enjoy walking up and down the stairs for added exercise but you can also use a treadmill which makes it very easy to track how far you’re walking. If you want, you can even purchase a device like a Fitbit which will track exactly how many steps you’re taking in a day and help you set long-term goals that are more achievable.
Stationary bikes are another great option for at-home endurance training. They’re especially great for COPD patients because they allow you to do something a little more interesting than simply walking and it also works different muscle groups like the hamstrings, quadriceps, and the soleus and gastrocnemius in the calves. You also don’t have to deal with things like balance or the threat of falling over and getting hurt while on a stationary bike.
Tai Chi is a long-standing Chinese martial arts tradition. While it’s been used for many purposes over the years, it’s commonly used by older adults and seniors as a form of exercise and meditation. We wrote a whole post on Tai Chi and it’s benefits, so check it out if you’re interested in learning more.
One of the main benefits of Tai Chi for people with lung conditions is that it allows you to tone your muscles, practice good posture and breathing, improve your endurance, and put your mind at ease all with one exercise. Tai Chi doesn’t involve fast-paced movements like other types of martial arts and it’s easy for beginners to jump into and start learning right away. According to COPD News Today, Tai Chi is an accessible, low-cost alternative to pulmonary rehabilitation.
Learn Strength Training Exercises
As aforementioned, muscle atrophy is a common occurrence in people with chronic obstructive pulmonary disease and other chronic lung conditions. According to this official publication, 40 percent of patients experience limited exercise capacity due to skeletal muscle loss in addition to pulmonary issues. This is often amplified by issues like oxidative stress, systemic inflammation, malnutrition, and hypoxemia.
What this means for those with COPD is that it’s extremely important to not only focus on improving your strength and working each muscle group, but you also don’t want to be losing more weight than you’re putting on. On the other hand, you don’t want to be overweight either because this can lead to problems like obstructive sleep apnea (OSA) and increase dyspnea (shortness of breath).
Much like endurance exercises, the strength training exercises you do don’t need to be high intensity. The consistency of your efforts is what will make the difference at the end of the day.
Resistance exercises are a key part of any COPD exercise program. Many patients may be intimidated by the thought of performing strength training with a chronic lung condition, but they should only be done under controlled conditions advised by your doctor. Since muscle atrophy can occur anywhere in the body, a full-body exercise routine is likely to benefit you most rather than one that targets a specific muscle group.
One concern many people will likely have is finding the right equipment to perform strength training while at home. If you normally have a gym, you probably don’t have weight machines around your home that you can use. In this case, you’ll have to use a mix of free weights, elastic resistance training, and body weight exercises. While not a lot is known about what exercises are most beneficial for COPD patients, Tom Storer, Ph. D. and former member of the Pulmonary Education and Research Foundation (PERF) board of directors, has put together a great guide for COPD patients interested in strength training.
Use a Portable Oxygen Concentrator
No matter what type of exercises you’re doing at home, one thing that can make your life a lot easier is the type of oxygen therapy device you’re using. A large portion of COPD patients are on oxygen 24/7 making it ineffective and difficult or near impossible to stay active. Luckily, there are alternatives to heavy and clunky oxygen tanks. Portable oxygen concentrators like the Inogen One G5 are lightweight, small, and easy to use, even when you’re up and moving around the house.
The G5 weighs in at just 4.7 pounds and it’s the size of a small handbag. This means you’ll be able to practice all the at-home exercise we mentioned previously without feeling restricted or confined to one space. Portable oxygen concentrators run on batteries and the G5 offers up to 13 hours of freedom on one charge. What this means is that you’ll be able to move around the house freely without your device being plugged into the wall or without long oxygen tubing that could be a tripping hazard.
Despite portable oxygen concentrators being easier to use, they are less expensive than alternatives like compressed oxygen and liquid oxygen. And since these are difficult financial times for many Americans, it’s best to have a long-term plan for managing your COPD symptoms. When compared side-by-side with there are far less costs associated with portable oxygen concentrators. While oxygen tanks need to be refilled regularly, POCs, will run for 5 to 7 years without needing any additional financial investments.
Last but certainly not least, portable oxygen concentrators are much safer than oxygen tanks. While concentrators remove oxygen from ambient air, oxygen tanks store oxygen at high pressures. This makes them significantly more prone to explosions or other safety issues. Portable oxygen concentrators also use pulse dose technology which only delivers oxygen when a breath is detected. If you happen to drop your nasal cannula, the flow of oxygen will stop, reducing the likelihood of a fire.
At Home Pulmonary Rehabilitation
Pulmonary rehabilitation programs are designed to educate COPD patients about their lungs and train them on proper techniques for exercising safely and effectively. Under normal circumstances, you would visit a specialist who will walk you through everything you need to know, but with the coronavirus being a clear and present danger, most pulmonologists will advise against in-person pulmonary rehab programs — fortunately, there are alternatives.
Thrive ePulmonary Learning is a fully online disease management course designed to help COPD patients understand their condition and implement proven breathing and exercise techniques that can reduce symptoms like breathlessness, chest pain, and coughing. By joining, you’ll have access to the following:
- One-on-one instruction from registered respiratory therapists, nutritionists, and counselors
- Exclusive access to your own support group
- Learn to manage your disease through treatment adherence, emotional health, diet, and exercise
- Step-by-step breathing exercises
- E-books and online guides
The best part about Thrive ePulmonary Learning is that you can gain access to the full program today for free with the purchase of a portable oxygen concentrator. Whether you’ve already been a part of a pulmonary rehab program or you’re looking into the idea for the first time, this is a great place to start.
In this day and age, there are so many things to occupy our thoughts that it often becomes overwhelming, especially if you already have a lot of things on your plate. If one good thing comes from the COVID-19 pandemic that we’re currently facing, it’s that people will have more time to focus on self-care and other important things that we may not have time for in our normal lives. For COPD patients, this could mean solidifying a plan to stay active.
No matter what stage of COPD you are in, physical ability, or age, it’s important to first discuss with your pulmonologist what’s best for you. If you’ve never had a lung function test before, this is most likely the first thing he/she will have you do because it will help determine what your exercise tolerance is and also reveal any potential risk factors of being involved in a pulmonary rehabilitation program.