Making some simple tweaks to exercises like walking and cycling can help you do them more easily if you have COPD.

Chronic obstructive pulmonary disease (COPD) is a group of lung diseases that can make it difficult to breathe. Chronic bronchitis and emphysema are the two most common conditions associated with COPD.

Exercise can help people with COPD use oxygen better, improve muscle strength, and reduce symptoms of anxiety and depression that may be associated with living with a chronic condition. Despite these benefits, however, many people with COPD face barriers to exercise.

You might fear becoming breathless or getting injured, or maybe you’re reluctant to exercise while using portable oxygen. You may be able to overcome these and other barriers by modifying your physical activity.

Physical therapist Dr. Gregory Minnis recommends starting with light to moderate exercise. You can work with a physical therapist or pulmonary specialist to create an custom plan that gets you started on an exercise routine and keeps you motivated to continue.

“The more physically active people are, the less likely they are to be depressed and anxious,” said Minnis.

“But when people are fearful of becoming breathless, or if they’re in a bad exercise program where they’re set up to fail, then they are less physically active,” he said. “The likelihood that you’re going to be depressed and anxious and fearful of movement becomes greater.”

“So it’s really important to set up a good individualized plan before you start,” Minnis added.

Many cardiovascular, breathing, and muscle-strengthening exercises can be adapted for people living with COPD. As you ease into your exercise program, you might want to start by aiming for cardiovascular activity that brings you to 40–50% of your maximum heart rate. And try to stop activities a few minutes before you get tired.

Always feel free to take a break when you need to, alternating between periods of rest and activity. As you get stronger, you might feel you can exercise for longer periods of time and take shorter breaks.

Joining a COPD support group or having an exercise companion can help you stay motivated to perform physical activity.

Minnis noted that people with a portable oxygen tank should be able to participate in exercise similarly to others with COPD who don’t use oxygen. The American Lung Association (ALA) also encourages exercising with your oxygen tank if you use one. A doctor can help you adjust your oxygen flow rate for physical activity.

Here are some examples of exercises you might want to try that can be adapted for COPD.

Walking can be done nearly anywhere by nearly anyone, regardless of fitness level. You can modify your walking pace and terrain and choose to adjust the level of difficulty.

Walking on a treadmill gives you the option to change the incline and speed. You can also place your hands on the treadmill bars for support.

If you use an oxygen tank, secure the tube that connects your nasal cannula to the extension tubing. You may use a clip to fasten the tubing to your shirt or waistband. You should also secure the tube that connects your nasal cannula to your oxygen source to avoid tripping over the tubing.

You can start at a slow walking pace and focus on taking slow breaths, the ALA suggests.

If you walk outside, consider a location where you have the option to rest. A local park with benches or shopping mall with seating are good options. If you need supplemental oxygen, a portable oxygen concentrator may be easier to carry and give you more freedom to walk outside.

Riding a bike also gives you the opportunity to adjust your level of difficulty and choose your preferred terrain.

If you use a stationery bicycle, you can adjust the resistance to meet your desired challenge level. Placing your arms at your sides or resting against the bike handles can allow you to alternate between different levels of exertion.

If you use an oxygen tank, be sure to secure the tubing that runs from your nasal cannula to the extension tubing and the oxygen source before you start cycling.

Outdoor bicycles come in various styles. You can adjust the gears to change the amount of physical or cardiovascular effort you put in. A bike with a motor can give you extra support for hills and other challenging terrain.

If needed, a portable oxygen concentrator may be a good choice when biking outdoors.

You can perform bicep curls while seated or standing. Sitting may help you conserve energy and allow you to keep your oxygen tank, if you use one, safely on the ground next to you.

Hold a weight or resistance band in your hand and slowly move your hand to your shoulder by bending at the elbow.

A resistance band can prevent overextending your arm, due to its limited range of motion. Instead of free weights, you can also use soup cans or any other household item you feel safe holding.

There are several ways to modify arm curls:

  • Stand up to engage your entire body’s muscles or stay seated to focus on the bicep.
  • Increase or decrease the weight size or band resistance.
  • Curl both arms simultaneously or curl one arm at a time.

If you’re living with COPD, it’s important to focus on your breathing, the ALA advises. Exhale on the hardest part of the bicep curl, when you bring your arm up toward your shoulder. Inhale on the easiest part, as you are moving the weight away from your shoulder.

Sit with your knees hip-width apart and your feet flat on the floor. Cross your arms across your chest. Push up to standing using your thigh muscles.

You can modify this exercise in many ways to fit your preferred activity level:

  • Sit on a higher chair to decrease the angle of the knee rotation from sitting to standing.
  • Place your hands next to your thighs on the chair and push off from sitting to standing.
  • Hold onto a chair or table in front of you for stability as you push off.

To add another element to the exercise, you can add in calf raises. Once you are in a standing position, move from flat foot to tiptoe and down again. You might want to place your hands on the chair or a wall for additional stability, especially if you’re carrying extra weight from a portable oxygen tank.

Sit comfortably with your back straight. Relax your neck and shoulders. Place your hands on your belly. Breathe in through your nose. Breathe out through pursed lips, taking two to three times as long to exhale as you did to inhale.

You have options to modify this exercise:

  • Lie down instead of sitting up so your body works against gravity.
  • Place a 1- to 2-pound weight just below your rib cage and focus on lifting the weight as you breathe in.
  • Press gently against your belly as you breathe in.

By lying down or adding weight, you create more resistance when you fill your lungs with air. This changes the challenge level of the exercise.

Tai chi is a movement practice that can help with balance and flexibility. You can join a tai chi class or learn the movements at home.

Because the movements are often slow, you might feel you can sustain the activity longer than with other whole-body exercises such as walking. Remember to take slow breaths and purse your lips upon breathing out.

You can modify a tai chi practice in a few ways:

  • Perform movement sequences from a seated position to help conserve energy.
  • Take a rest during a class by moving from a standing to a seated position.

Tai chi may be a good option if you use oxygen, as the tank likely won’t get in the way of the slow, fluid movements. Just be sure to secure any tubing before you start. You may also wish to use a portable oxygen concentrator or perform the moves while seated.

If you’re doing tai chi as part of a group, you might want to discuss your COPD with your instructor and explain that you might need help modifying your movements during the class.

Exercise can play an important role in helping to manage COPD. But symptoms such as breathlessness and fatigue may make people hesitant to start a workout routine.

Modifying cardiovascular, breathing, and muscle-strengthening exercises can make them easier for people with COPD to perform. If you’re new to exercise, start slowly and aim for activity that brings you to 40–50% of your maximum heart rate. You can gradually increase the amount of time you exercise and the intensity of your workout.