One of the things my patients were most concerned about when we temporarily closed our pulmonary rehab due to COVID-19 was losing ground with their conditioning. Many of my patients had made a ton of progress with improving their endurance up until that point. Obviously, it was the right thing to close temporarily for the safety of our patients and as a suggestion from the CDC, but how do my patients with chronic lung conditions continue to improve their endurance in the meantime?
The other challenge is the fact that many areas in the U.S. have stay-at-home orders and advisories, so visiting your local fitness facility isn’t an option. I had to come up with some ideas for you to get a good cardio workout and increase your endurance in the comfort of your own home when you have a lung condition. I tried to keep in mind when making this list that many of my readers wear supplemental oxygen. There are so many cardio-inspired exercises out there, but I wanted to keep in mind that many of you are managing oxygen tubing at the same time. So these exercises are “doable” for those of you who have to wear it.
Words of advice (please read through all points as they are all equally important):
- Always check with your doctor before starting something new. Many physician offices are keeping different hours due to COVID-19, so try reaching out through your “patient portal” or leaving a message for the nurse to return your call. You will want to find out what guidelines, if any, they might have before you begin. They might have some recommendations for heart rates and supplemental oxygen flow rates.
- If you have been ordered oxygen for exertion or continuous use, be sure to wear it while exercising. Your muscles utilize oxygen for energy; therefore, you could provide them with adequate oxygenation while working out. Make sure you have plenty of extra tubing for moving about.
- “If it hurts, don’t do it.” I think I probably say this phrase a hundred times a week in regard to people with lung conditions working out. Our focus is NOT “no pain, no gain.” We want to exercise to the point of “stretch.” If any of the exercises you are performing are causing you physical pain, you need to stop and try something different. Don’t risk injuring yourself (especially during this time) by continuing to do an exercise that is causing discomfort. Also, while performing the exercise, if it becomes difficult or you start experiencing shortness of breath that is difficult to manage, stop and rest OR slow down to see if your breathing can “catch up.”
- Practice using breathing techniques like pursed-lip breathing or diaphragmatic breathing while performing any cardio exercise. These breathing techniques may help to keep your oxygen levels in a “safe zone” and can help focus your efforts on controlling your level of breathlessness, as well.
- Consider using your “rescue inhaler” or short-acting bronchodilator before you get started. Prior to starting any cardio exercises, you want to be breathing at “your best.” If you get improvement after using your rescue inhaler or short-acting bronchodilator, have it in your system to assist with your breathing while exercising. It just might make the exercise a bit easier, or perhaps allow you to recover faster when you complete your exercise.
- Monitor your oxygen saturation. In our pulmonary rehab, we try our best to keep our patients’ oxygen saturation greater than 90% throughout their exercise routine. We do this by monitoring with a pulse oximeter. My recommendation is if you are going to start exercising at home, you should invest in a pulse oximeter to make sure that your oxygen levels stay in that “safe zone” (90%-100%). You can find the one pictured below on Amazon. I was finding while doing research for this blog that the prices and availability of pulse oximeters on Amazon had changed from previous months due to COVID-19. You can also check out Walmart and other online retailers to see if they are more readily available.
- Start slow. Don’t take the risk of pushing your body in an unsafe way. Be conservative with your approach. If it has been a while since you have exercised, don’t believe that you can start back where you left off. We tend to make a recommendation to our patients when they return to pulmonary rehab after an extended absence to “cut their time in half.” This conservative approach takes some pressure off my patients and allows them to see how their body responds to returning to exercise. Often, we don’t know until the next day whether the amount of exercise was too much or not… start slow. You won’t be sorry that you did.
- Keep a log. Physicians LOVE to see their patients taking a proactive approach to their fitness. Keeping a log of the exercise that you are doing at home allows you to track your progress with your exercise. It will also allow you to show your pulmonary rehab team, gym, or physician what you have been doing for exercise. This will allow them to make recommendations for you once you are able to return to your normal workout routine when COVID-19 isn’t so much an issue where you reside.
Here are some ideas for how you can get a good cardio workout at home:
Dust off the exercise equipment you already have
This might seem obvious, but I had to mention it. If you have equipment like a treadmill or a stationary bike (take the laundry or boxes off of it), clean it off and start using it. If your equipment hasn’t been used in years, I would inspect cords and plugs to make sure they aren’t frayed. You may need some WD40 (or another lubricant) if bicycle wheels are hard to turn from lack of use.
Walk in place
It is that simple. Put on your favorite tunes or the latest show that you are binge-watching and simply walk in place. Tighten your core for extra abdominal strengthening while you walk. For greater difficulty, add a few “high knees” (essentially raising your knee up high to almost hip level). You might be surprised how just walking in place for a prolonged period of time can give you the exercise that you need. Make sure you set a timer so that you can monitor how long each “walking interval” is before you have to stop to rest. Don’t forget your breathing techniques!
You can use this in combination with intervals of walking in place. It will also improve side movement coordination. Stand with your feet hip-width apart, knees slightly bent. Tighten your core for an extra tummy workout. Lift your right foot, push off your left foot, and move right while keeping your form. Place your feet together. Continue shuffling to the right. Repeat the same steps to the left side. Move back and forth to each side of your workout areas. Make sure you use your breathing techniques. Time yourself and log that into your logbook.
One of my favorite pieces of exercise equipment for home use is a pedal exerciser. I love them because they don’t break the bank, they are light in weight, and you can work out your legs AND your arms (by placing it on a tabletop). My favorite types of pedal exercisers are ones that you can adjust the resistance to increase the difficulty as you build your strength. The other plus is that they are small and can easily be stowed away when not in use. Remember to set a timer with these if your model doesn’t have one and, if you add resistance, notate that (and how much) in your logbook. I have included one below that is pretty popular on Amazon. Feel free to check it out by clicking on the link below. They have fancier models available but, for the cost, this one rated well and was in stock.
One of my favorite ways of getting a great workout is a dance party with my kids in the living room. Not only is it a great way to lift the spirits during this time but, for my kids, me dancing is sure to generate some giggles. Seriously though, dancing can give you a wonderful workout to help you increase your endurance. Grab a partner or go stag to your own dance party with your favorite tunes. You’ll thank me later. J
After spending so much time cooped up in my house, I like to get outside. If you are adequately conditioned, you may want to go for a walk around your home or in your neighborhood. Make sure you take your pulse oximeter for monitoring and your cell phone just in case of an emergency. Keep in mind, “free walking” can be challenging because there aren’t many places to sit down to rest. So if you haven’t been exercising recently, you may want to “work up” to being able to walk outside on your own. Don’t shy away from using any assistive devices like a rollator to help support your upper body, assist with balance, and provide you with a seat if you need it.
Bottom step up/downs
Steps are super challenging for people with lung conditions. A way to strengthen your legs and increase your endurance is by practicing with the “bottom” step on your staircase. Have a chair nearby for resting. Use the handrail and step up with both legs: right foot first, then left; then, step down. Next, step up with your left leg first, followed by your right, and then step down. Only use the bottom step! You don’t want to wear out and be halfway up the steps with nowhere to sit and possibly at a balance risk. Using your bottom step only with a handrail for stability will give you enough of a challenge to get a great workout. Be sure to monitor your oxygen levels and how many steps you climbed for your workout. Start with a low number! You will feel these later.
Thanks for Reading and Stay Well! Remember: We are in this TOGETHER!
Christina Hunt’s work can be found at BreatheLiveFit.com. You can also visit her on Facebook and Instagram for other practical advice and inspirational posts.
About the author: Christina Hunt is a registered respiratory therapist and blogger who has been working in the field of respiratory care for the last 19 years. She obtained her bachelor’s degree from Virginia Tech in Human Foods, Nutrition, and Exercise in 2001. For the last 10 years, Christina has worked in pulmonary rehab and in 2018 developed a blog called BreatheLiveFit.com. Christina is passionate about helping people with chronic lung conditions live happier, healthier lives. She volunteers her time as the Virginia state captain of the COPD Foundation and serves as a board member for Breath Matters Support Group of Virginia.
(This article has not been reviewed by the Pulmonary Fibrosis Foundation.)