Emphysema And Physical Activity

If you have emphysema, you will often feel short of breath. So you might see exercising as an absurd thing to do. But physical inactivity leads to muscle weakness and increases shortness of breath. It’s a vicious cycle whereby difficult breathing makes you unwilling to exercise but staying inactive only worsens your symptoms. Physical activity improves your lung function, helps you breathe better, prevents other chronic conditions, and improves your quality of life. Many exercises are good for emphysema including walking, cycling, gardening, or resistance training.

What is emphysema?

Emphysema is a type of lung damage that makes it difficult to breathe. It is caused by cigarette smoke or constant inhalation of air pollutants which weaken and damage the tiny air sacs (alveoli) in the lungs. These air sacs are responsible for the exchange of gases (oxygen and carbon dioxide) with blood. 

Over time, the damaged alveoli collapse to form larger ones. This reduces the surface area available for gaseous exchange. The larger sacs also become hyperinflated, that is, the air gets trapped in them. These hyperinflated sacs block the healthier parts of the lungs from efficiently exchanging gases with blood. These make breathing tasking for your lungs. Emphysema and chronic bronchitis are part of a group of diseases known as chronic obstructive pulmonary disease (COPD).^1,2 

Symptoms

The symptoms of emphysema usually start mild and become worse as the disease progresses. Common symptoms of emphysema include

• Shortness of breath
• A constant cough
• Wheezing 
• Phlegm
• Weight loss
• Physical inactivity or body weakness.^2,3

You should meet with your doctor if you notice any of these symptoms. If you’ve been diagnosed with emphysema, call your doctor if your symptoms suddenly become worse.

Breathing during exercise

The respiratory system (the lungs and the air passageways) has extra work to do during exercise. When you exercise, your muscles consume more oxygen and produce more carbon dioxide. This increases as the exercises become more intensive. 

To meet this demand, the body increases the breathing rate from about 15 breaths per minute to about 40–60 breaths per minute. The volume of air inhaled and exhaled also increases from about 12 litres of air to about 100 litres of air. 

Depending on how long you exercise and how intense it is, your respiratory system will keep compensating for what your muscles need until it reaches a maximum point. After this, your body will build up an oxygen debt that has to be repaid when you’re done exercising. Your breathing will take a while to get back to its resting rate and volume to repay this debt.

The lungs have a breathing reserve that helps to provide air during exercise. But if you have emphysema, your reserve will likely be low. This can make exercising tasking for your lungs. You should give yourself time to recover at intervals while you exercise. If your breathing/or pain becomes unbearable during exercise let your doctor know.^4,5

Benefits of exercising with emphysema

Exercising has many overall benefits. It improves your physical and psychological well-being  and prevents diseases like type 2 diabetes, stroke, heart disease, and depression. If you have emphysema, you already find it difficult to breathe and the notion of exercising might be scary. But as you exercise more often, your muscles will become stronger. You will also require less oxygen and produce less carbon dioxide to perform the same kind of workout. This means that it will become less tasking on your lungs. Also, performing your regular activities will become less burdensome as you’re essentially training your lungs with exercise to handle less demanding tasks.⁵ Exercising also slows down the progression of emphysema and helps you cope with the disease. But the benefits of exercising for emphysema do not last long. So, you should form a habit of exercising regularly.⁶

Pulmonary rehabilitation 

Pulmonary rehabilitation is an outpatient treatment program for people with COPD and other lung diseases. This program aims  to help you cope with your condition and improve your quality of life. This is achieved through exercise training as well as educating you about your condition. At the end of the program, you’ll be more confident in managing and being active with emphysema. The program is typically done in a group so you’ll meet and get support from other patients. The program is carried out by a trained clinical team for a few weeks. You can use the skills you get from the program to manage your condition afterwards.^7,8

What type of exercise is best for emphysema?

If you have emphysema you should meet  with your doctor before you start exercising. Your doctor will evaluate you and advise you on the best exercises to perform. Your doctor might recommend a pulmonary rehabilitation program to help you get started.⁹ You can also get help from a coach (in person or online) or an emphysema exercise program. Your breathing is also important when you exercise. Diaphragmatic breathing and pursed lip breathing are good techniques that can help you.

Low-intensity/moderate exercise

What matters when you start exercising is consistency and not the intensity of your workout. Low or moderate-intensity  exercises are a good way to start especially if you easily become breathless. Some exercises you can perform include:

Stretching

Stretching can be a good way to start any workout. Stretching your neck, chest, and back gives your lungs more room to expand which will help you breathe easier. Stretching after a workout is a great way to cool down and reduce muscle soreness. Practices like yoga and tai chi that incorporate stretching help reduce stress and anxiety which is common among emphysema patients.¹⁰

Aerobic exercise

Aerobic exercises are exercises that get your heart rate up. This includes exercises like walking, riding a bike, or swimming. Aerobic exercises strengthen your heart muscle and reduce the amount of oxygen your body needs for less demanding tasks. This reduces the burden on your lungs.¹¹

Resistance exercise

Muscle weakness is common among people with emphysema. This is because of the inactivity associated with the disease. Resistance exercises increase muscle strength. They also improve lung function and reduce shortness of breath.¹² Performing resistance exercises can be done with weights or resistance bands. You can also use your body weight to perform sit-ups, planks, and squats.

Summary 

Becoming more physically active is important if you have emphysema. It slows the progression of the disease and helps you cope with it. You can start with a pulmonary rehabilitation program or perform stretching, aerobic or resistance exercises. You should let your doctor know about any exercises you wish to perform so you can be guided.