Please note

that these recommendations have been produced specifically to help people with, or at risk of, a long term condition, aiming to do moderate activity only.

Chronic Obstructive Pulmonary Disease (COPD) prescription

COPD and Physical activity

Chronic obstructive pulmonary disease (COPD) is diagnosed airflow to the lungs is restricted (obstructed). COPD is usually caused and made worse by smoking. Inhalers can help ease symptoms but they do not cure COPD. Breathlessness caused by COPD can be very frightening and as a result many people reduce the amount of activity they do. In the long term, this physical inactivity not only increases your chance of developing heart and circulation problems but it leads to a feeling of being tired, unfit and even more breathless. Starting and maintaining regular activity in COPD can improve breathing and ease symptoms – over time, you can feel less breathless as you get fitter. People who are spend time doing exercise feel less frightened by doing more and become more active in their daily lives. 1  Evidence shows that being physically active is one of the strongest predictors of living a longer life in COPD. 2

Regular physical activity also gives you more energy, builds confidence and can help you to sleep more soundly at night. You can combine your activity time with family and friends or use it as an opportunity to reflect on things and listen to your favourite music.

Physical Activity Recommendations for inactive adults with COPD

Aim to do the following three types of activity:
  • Aerobic activity at relative moderate intensity for at least 150 minutes (2 hours and 30 minutes) a week – one way to approach this is to do 30 minutes on at least five days each week.
  • Muscle strengthening activity on two or more days a week which work all major muscles groups (legs, hips, back, abdomen, chest, shoulder and arms)
  • Flexibility exercises on a daily basis
Do not worry if you struggle to meet the Guideline, because by trying to become more active, you are still gaining some health benefits.

The Three Types of Activity and COPD

You may find the following weekly approach useful if you have been inactive for a while.

Aerobic activity


Aerobic activity, also known as endurance activity, is when large muscle movements, maintained over a period of time, make the heart and lungs work harder.

Activity? – Any type that you can maintain comfortably is ideal. Choose exercises that you enjoy, such as walking, cycling or group fitness classes. Aerobic activities are really important if you want to improve the health of your heart and circulation.

How long (duration)? – You can split your total activity amount into minimum bouts of 10 minutes if needed. If you have been inactive for a long time, start with short daily amounts and increase this as your body allows and you feel more confident. Remember not to sit for hours. A regular break from sitting every hour is healthy.

How hard (intensity)? – Progress slowly to a relatively moderate-intensity activity. When doing moderate intensity activity you will feel warm, mildly out of breath and mildly sweaty. The ‘talk test’ is a simple way to measure moderate intensity. This means that you can still talk, but not sing, during the activity. Getting out of breath when increasing your activity level is a normal body response to exercise. Monitor your improvement over time by keeping a track of breathing comfort levels during activity.

How often (frequency)? – If you aim to do 30 minutes per day then do this at least 5 times per week so that you reach the 150 minutes total per week. Distribute the sessions over the week and aim to have no more than 2 consecutive days without physical activity. When you start any new activities make sure you give your body enough

Muscle Strengthening


Simple strength training on at least 2 days a week is important for health. Improved muscle tone can also help you gain better shape and improve the way you look and feel. Some activities, such as climbing stairs, digging the garden or walking up hill, combine aerobic and muscle strengthening types.

These activities should work all the major muscle groups in your body such as legs, hips, back, chest, abdomen, shoulders and arms. When strengthening a muscle group, begin by familiarising the movement with little or no load.

If you are using weights such as dumbbells, try to do at least 1 set of 8-12 repetitions per activity. The correct weight choice is the one which is hard to complete by the end of the set. A repetition is one complete movement of an activity, like doing a sit up or bicep curl.

Flexibility Exercises


Daily flexibility exercises can prevent pain, stiffness, and injury of muscles and joints. People often experience a sense of wellbeing and relaxation during flexibility exercises. Some quick and simple movements can be found in our separate exercise sheet. Yoga, Tai Chi and Pilates are examples of some activities which combine strength and flexibility as well as balance training. Some people find that Yoga stretches, which are performed in harmony with breathing, are beneficial in COPD.

Safety considerations

  • If you have led a very sedentary lifestyle, begin by doing low intensity exercise of short duration, e.g. 10 minutes.
  • Stop exercising if you feel dizzy, sick, unwell or very tired.
  • See a doctor if you are having chest pain, black outs or breathlessness on mild exertion.
  • Avoid physical activity if your breathlessness is severe and uncontrolled by your medicines at rest.
  • Always have your reliever inhaler with you when you exercise.
  • Do a gentle warm up.
  • Avoid physical activity if your breathlessness is severe and uncontrolled by your medicines at rest. You may need to be reviewed by your healthcare professional.

Please see the following safety considerations if you have other long term health conditions.


This leaflet has been provided for information only. ALWAYS check with your doctor if you have any concerns about your condition or treatment. is not responsible or liable, directly or indirectly, for ANY form of damages whatsoever resulting from the use (or misuse) of information contained in or implied by this information.

Further reading

  • Start Active, Stay Active – a report on physical activity for health from the four home countries ‘ Chief Medical Officers. UK Department of Health, July 2011.
  • ACSM’s Guidelines for Exercise Testing and Prescription, American College of Sports Medicine, 2009
  • Swedish National Institute of Public Health. Physical Activity in the Prevention and Treatment of Disease. Professional Associations for Physical Activity, Sweden, 2010. COPD. 271-281.


  1. Lacasse Y et al. Pulmonary rehabilitation for chronic rehabilitation for chronic obstructive pulmonary disease. Cochrane database of systematic reviews (online) 2022:CD003793
  2. Waschki et al. Physical Activity is the Strongest Predictor of All-Cause Mortality in Patients with COPD.Chest, Aug 2011 vol 140 number 2 331-342

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