Exercise with respiratory conditions
By Matheus de Paiva, Exercise coach, BSc Physical Therapy, MSc Rehabilitation Science. Updated 2026-10-03.
Exercise is one of the most effective treatments for chronic lung conditions. Pulmonary rehabilitation, which is built around exercise, reduces breathlessness and improves quality of life in COPD. Some breathlessness during exercise is expected and safe. The goal is to build tolerance gradually while using breathing and pacing strategies.
Who this guide is for
- COPD
- Asthma, including exercise-induced asthma
- Bronchiectasis
- Interstitial lung disease
- Breathlessness after a respiratory illness
What the evidence says
International COPD guidelines recommend pulmonary rehabilitation with aerobic and strength training for people with breathlessness. Benefits include better exercise capacity, less breathlessness and fewer hospital visits.
Leg strength is closely linked to how far people with lung conditions can walk. Strength training makes daily activities feel easier on the lungs.
How to start
- Start at a level that feels easy to moderate, about 3 to 5 out of 10 effort, and build slowly over weeks. How you feel the next day matters as much as how you feel during the session.
- Use a breathlessness scale. Moderate breathlessness, where you can still speak in short sentences, is a good training zone.
- Try interval training: short bouts of effort with rest between them often allow more total work with less breathlessness.
- Use pursed-lip breathing and breathe out during the hardest part of each movement.
- With asthma, follow your action plan, warm up gradually, and keep your reliever inhaler with you.
When to check with a health professional
- Breathlessness that is much worse than usual or does not settle with rest
- Chest pain, lips turning blue, or confusion
- A chest infection or flare with fever or changes in sputum
- If you use oxygen, ask about the right flow rate for exercise
Common questions
Is it safe to get out of breath with COPD?
Yes, moderate breathlessness during exercise is expected and safe for most people with COPD. It should ease within a few minutes of rest.
What is the best exercise for COPD?
Walking or cycling combined with strength training for the legs and arms. Interval training can help if continuous exercise is too breathless.
Can people with asthma do intense exercise?
Yes, when asthma is well controlled. Warming up well and using medication as prescribed allows most people with asthma to train fully.
Sources
- GOLD Global Strategy for COPD
- McCarthy et al. 2015, pulmonary rehabilitation for COPD (Cochrane)
- Spruit et al. 2013, ATS/ERS statement on pulmonary rehabilitation
- Lung Health Foundation: living with lung disease
These guides are general education and do not replace advice from your doctor or health team. True Pace does not diagnose or treat medical conditions.