COPD Exercise Tolerance and COPD By Deborah Leader, RN Deborah Leader, RN Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD. Learn about our editorial process Updated on April 19, 2022 Medically reviewed by Sanja Jelic, MD Medically reviewed by Sanja Jelic, MD Sanja Jelic, MD, is board-certified in sleep medicine, critical care medicine, pulmonary disease, and internal medicine. Learn about our Medical Expert Board Fact checked by Angela Underwood Fact checked by Angela Underwood LinkedIn Angela Underwood's extensive local, state, and federal healthcare and environmental news coverage includes 911 first-responder compensation policy to the Ciba-Geigy water contamination case in Toms River, NJ. Her additional health-related coverage includes death and dying, skin care, and autism spectrum disorder. Learn about our editorial process Print Exercise tolerance refers to the exercise capacity of an individual as measured by their ability to endure exercise and/or the maximum workload achieved during the exercise period. Exercise tolerance can be measured accurately during an exercise tolerance test. Marc Romanelli / Blend Images / Getty Images People with chronic obstructive pulmonary disease, or COPD, have a reduced capacity for exercise/activity due to dyspnea and fatigue, which stem from an inadequate oxygen supply within the body. Over time, even the slightest tasks, such as getting dressed, can cause difficulty. Fortunately, research shows that getting regular exercise can reduce COPD symptoms, improve energy, increase endurance and help you feel better overall. Here’s what you need to know about starting an exercise program with COPD. Before Beginning Exercise If you have COPD, visit your healthcare provider before beginning any exercise program. Your healthcare provider may have you perform an exercise tolerance test. Also called a stress test, the exercise tolerance test, or ETT, involves walking on a treadmill at varying levels of difficulty while being connected to an electrocardiogram or ECG. During the test, your healthcare provider will monitor your blood pressure, heart rate, and EKG before, during and after activity using electrodes attached to your chest. The test begins with you lying down at rest, then again while standing. Next, you will be asked to walk on a treadmill at varying speeds. After the test results have been interpreted, your healthcare provider will give you guidelines for starting an exercise program. Be sure to ask lots of questions so you are clear about how long you should exercise for and how often, the types of exercises to do and not to do, and if you will need to make any changes to your medication timing or dosages. Exercising With COPD Your healthcare provider should help you to develop an exercise program that includes stretching, strength training, and cardiovascular exercise. Stretching exercises include the slow lengthening of the muscles, which, when done regularly, increases your range of motion and flexibility. This should be done before exercising to prepare the muscles for activity and prevent injury and after exercising to cool down and prevent muscle strain. Strength training involves repeated muscle contractions or tightening until the muscle becomes tired. In patients with COPD, upper body strengthening exercises are especially helpful for people to increase the strength of your respiratory muscles. Cardiovascular or aerobic exercises, such as walking, jogging, cycling, rowing, dancing, and water aerobics, use large muscle groups to strengthen the heart and lungs and improve the body’s ability to use oxygen. While this may be difficult at first for people with COPD, research shows getting regular cardiovascular exercise can improve your breathing, and decrease your heart rate and blood pressure. Be sure to follow your healthcare provider's exercise instructions precisely and to contact the office if you have any questions, concerns, or pain during exercise. 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Khan I, Hasan M, Hasan J, Dhillon AI, Khan M, Kaneez M. Gauging the positive predictive value of exercise tolerance test using angiographic evaluation: a cross-sectional analysis from a developing country. Cureus. 2020 Dec 19;12(12):e12173. doi: 10.7759/cureus.12173. Louvaris Z, Chynkiamis N, Spetsioti S, et al. Greater exercise tolerance in COPD during acute interval, compared to equivalent constant‐load, cycle exercise: physiological mechanisms. J Physiol. 2020;598(17):3613-3629. doi: 10.1113/jp279531 Burkow TM, Vognild LK, Johnsen E, Bratvold A, Risberg MJ. Promoting exercise training and physical activity in daily life: a feasibility study of a virtual group intervention for behaviour change in COPD. BMC Medical Informatics and Decision Making. 2018;18(1):136. doi: 10.1186/s12911-018-0721-8 Vaidya GN. Application of exercise ECG stress test in the current high cost modern-era healthcare system. Indian Heart J. 2017;69(4):551-555. doi: 10.1016/j.ihj.2017.06.004 Rehman A, Ganai J, Aggarwal R, Alghadir AH, Iqbal ZA. Effect of passive stretching of respiratory muscles on chest expansion and 6-minute walk distance in copd patients. International Journal of Environmental Research and Public Health. 2020;17(18):6480. doi: 10.3390/ijerph17186480 Berry MJ, Shields KL, Adair NE. Comparison of effects of endurance and strength training programs in patients with copd. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2018;15(2):192-199. doi: 10.1080/15412555.2018.1446926 Mohammed J, Derom E, Van Oosterwijck J, Da Silva H, Calders P. Evidence for aerobic exercise training on the autonomic function in patients with chronic obstructive pulmonary disease (Copd): a systematic review. Physiotherapy. 2018;104(1):36-45. doi: 10.1016/j.physio.2017.07.004 Additional Reading Cleveland Clinic. COPD Exercise & Activity Guidelines. By Deborah Leader, RN Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit